Decision Support Specialist 3 - UCI Health Plan Administration - FT Days

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.

As Orange County's only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region's only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Position Summary:

Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance system's operational, financial and strategic decision making. Includes the development of a case-based.

Required Qualifications:

• Understanding of value-based risk arrangements.
• Thorough understanding of decision support systems, with knowledge of business statistics, quantitative methods, relational databases, business development scorecards, data modeling, and performance and profitability analysis.
• Thorough knowledge of issues in clinical finance, planning, financial data management, and business development. Skills to effectively utilize the tools to produce meaningful findings and actionable intelligence.
• Strong written and verbal communications skills, with the ability to interpret and convey complex technical and financial information in a clear, concise manner, and to make cogent presentations of analyses, reports, and investigation results.
• Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong problem-solving skills and analytical ability, and strong knowledge of documentation and reporting, with the ability to run queries, complex studies, and forecasts.
• Strong interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment with interdepartmental personnel at a variety of professional and technical levels.
• Strong critical-thinking and attention to detail.
• Proven ability to work with senior staff and managers across departments, serving as a technical resource in decision support, and providing recommendations and advice on decision support processes, business and financial issues, and industry trends and advances.
• Proficient in Microsoft Office suite products, key skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
• Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
• Knowledge of health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
• Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
• Effective verbal and written communication skills.
• Detail oriented, with strong ability to effectively manage time. Skills to effectively address complex, urgent issues as they arise.
• Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
• Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
• Demonstrated problem-solving skills.
• Bachelor's degree in statistics, mathematics, finance, economics, computer science, health care management or related field.
• At least 3 years of health care analytics and/or medical economics experience, or equivalent combination of relevant education and experience.
• Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
• Ability to mine and manage information from large data sources.

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment:

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement:

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m.