Job description
Full job descriptionKPI Tracking and Reporting:Assist in the collection, organization, and analysis of utilization management KPIs for reporting to senior leadership and payers.Generate regular reports and dashboards in collaboration with the Data Analytics team.Utilization Analysis:Conduct analyses of concurrent and retrospective claims to identify primary utilization drivers by provider, physician, and service.Contribute insights into utilization trends and cost drivers using data visualization tools.Segment and Payer-Level Data Review:Perform data reviews on utilization patterns across business segments and payers to support targeted performance improvements.Provide input on payer-specific utilization trends to aid in developing remediation plans.Large Policy Support:Contribute to large policy utilization management by analyzing data on outlier claims and high-risk members.Assist in identifying potential interventions or consultations needed with payers.Education: Bachelor’s degree in healthcare management, statistics, or a related field.1. Data Analysis and InterpretationAnalytical Proficiency: Ability to analyze concurrent and retrospective claims data to identify utilization trends, drivers, and cost-saving opportunities.Data Interpretation: Skilled in drawing meaningful insights from complex data sets, understanding the implications of utilization patterns, and translating findings into actionable recommendations.2. KPI Monitoring and ReportingPerformance Metrics Management: Proficient in establishing, monitoring, and reporting on utilization management KPIs, ensuring that performance aligns with organizational and payer expectations.Regular Reporting: Ability to create clear and comprehensive reports for senior leadership and payers, showcasing trends, areas of concern, and improvements.
Responsibilities & skills
Education
Performance Metrics Management: Proficient in establishing, monitoring, and reporting on utilization management KPIs, ensuring that performance aligns with organizational and payer expectations.Regular Reporting: Ability to create clear and comprehensive reports for senior leadership and payers, showcasing trends, areas of concern, and improvements.
Experience
Ready to apply?
Sign in and make sure your profile and resume are up to date.
Dubai Insurance TPA
This role is responsible for providing efficient clerical and organizational assistance to ensure smooth daily operations. This includes managing schedules, handling correspondence, maintaining records, and supporting internal teams with administrative tasks. The position serves as a key point of coordination to facilitate communication and workflow across the organization.
View company profile
