Clinical Report Analyst, Health Plan

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. 

Union Position:

Department Details

The Clinical Analyst will review integrated clinical and administrative data to support business functions and processes. Work independently to compile and conduct ongoing analysis and evaluation of claims, reports and clinical data for quality, risk, forecasting and cost impact. Follow standard practices and procedures in analyzing situations or data from which answers can be researched and obtained. Provide referrals to applicable teams, as appropriate, upon data findings. Provide clinical input to the Underwriting and Finance teams for quoting and renewing groups as well as forecasting and risk identification. Maintain a working knowledge of the data sources to accurately and efficiently report findings in a meaningful, understandable and concise manner. Establish effective mechanisms of communication with stakeholders and the organization's management team to foster an environment of openness, trust and team work. Complete special projects and management reports as assigned. Develop, analyze and monitor new, routine and ad hoc reports. Serve as a consultant with new business opportunities and plays a critical role in the annual renewal review of clients. Support Account Executives where needed on client engagement meetings, clinical review analysis and has effective presentation and communication skills. Communicate current medical management programs and cost containment strategies to assist in supporting client retention and addressing utilization trends. Collaborate with the integrated team and partners in order to provide a seamless exchange of information between internal departments including the Underwriting, Finance, Actuary, Sales and Retention, Care Management teams and brokers with the ultimate outcome to improve quality, reduce costs and enhance the client experience. Ability to work independently or as a member of a team. Ability to multitask and work with little direction. Limited travel may be required as necessary. Demonstrate proficiency with Epic/Tapestry and Microsoft applications.

Sanford is an EEO/AA Employer M/F/Disability/Vet. 

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [email protected].