KPMG - Business Analyst - Claims - Healthcare

KPMG Global Services is actively seeking Healthcare Business Analyst having various levels of experience. You will be a member of the KPMG Data & Analytics team will work with cross disciplinary team comprising of domain consultants, end users, software engineers, statisticians and visualization experts. You will work on engagements to generate insights for leading healthcare organizations in areas such as claims analytics, population health, disease management and clinical quality. You will address healthcare problems through data analytics, namely - domain expertise, medical coding etc.

Key responsibilities:-

- Translate business requirements, develop business cases, and recommend solutions. Be client focused, Drive best practices through business processes knowledge

- Perform research to identify business problems and ability to breakdown complex business issues to come up with solutions through extensive data analysis

- To create analytical products on claims data coming from Payers (medical & Rx), CMS, Commercial Claims, PBMs etc. and understand how they are aligned to each other & there significance also to create insights and perform analysis like comparative rate between healthcare products, reimbursement & cost analysis, financial impact calculations, and national or regional market analysis related to healthcare products and similar analysis on this area of work

- Work on Healthcare Space comprising Payers (Medicare/Commercial plans), Pharmacy Benefit management, Healthcare Provider/ACO organization's etc.

- Perform activities which is part of bigger solution using ICD9, ICD10, CPT, HCPCS classification system .Provide insights to the core analytical team on the medical markers and work with them on the advanced analytical project

- Perform analytical activities using Microsoft Excel and SQL and can use or pick up any analytical tool which is organization specific.

Candidate Profile:-

- Demonstrated work experience in healthcare/ life sciences data analytics programs for minimum of 5 years. Experience on Medical coding related to ICD9, ICD10, CPT, HCPCS classification system

- Graduate/ Post Graduates in Biostatistics/Operations Research/healthcare management/allied discipline

- Possess significant experience in clinical and/ or healthcare claims data, healthcare reforms programs and claims (medical & Rx) data coming from Payers, CMS, Commercial plans, PBMs

- Prior experience in analyzing healthcare claims data, developing comparative rate and reimbursement analysis, cost analysis and financial impact calculations, and national or regional market studies.

- Strong analytical skills with the ability to collect, organize, analyze data using Microsoft Excel and SQL and can use or pick up any analytical tool which is organization specific.

- Working knowledge of health care analytics in a Providers, Payers, Pharmacy Benefit management, and Healthcare Provider/ACO organization's is mandatory