Gather all relevant data through system or manually from claims and pre-authorization.
Gather all relevant data through system or manually from claims and pre-authorization.
Ensure the data is clean and free from errors or duplication, and data organization.
Utilize statistical and analytical techniques to delve into the data, identify member's behavior, trends, and anomalies, and extract valuable insights.
Collaborate with pricing team to use forecasting models and techniques to report future claim trends based on historical data and current market conditions.
Conduct scenario analysis by simulating different scenarios & assessing their potential impact on claims data.
Create infographic presentations to communicate findings effectively to stakeholders.
Continuously refine analysis methods, explore new tools and technologies.
Collaborate with internal departments (Pricing, pre-auth, claims, TQM, etc.) to Identify specific metrics or benchmarks relevant to their area of data, such as member's frequency, unit cost benchmark, or customer satisfaction/NPS benchmark.
Gather relevant data regularly from various sources, including systems, dashboard, or manual records.
Analyze any variance or deviations from the targets to understand the causes and identify areas for improvement or corrective actions.
Communicate with RM's or clients to understand the client specific requirements, objectives, and KPIs that they want to monitor.
Determine the data sources and metrics necessary to track the client's KPIs.
Choose appropriate visualization techniques (e.g., charts, graphs, tables) to represent the data in a clear and understandable format that aligns with the client's preferences.
Collaborate with IT and Digital factory for dashboard execution and follow up.
Determine the specific objectives or targets for saving.
Research and gather information on various saving models and strategies available locally or internationally, including cost-cutting initiatives, process improvements, automation technologies, outsourcing options, and negotiation tactics.
Collaborate with pricing team to evaluate the feasibility and suitability of each saving model.
Collaborate with pricing team to estimate the potential savings or cost reductions associated with each saving model by analyzing historical data and conducting financial projections.
Assess the risks, trade-offs, and potential drawbacks of implementing each model.
Go online regularly to Insurance authority (IA) and CHI and stay up to date about market updates.
Look at competitor's websites to compare against ours and identify gaps.
Follow IA and CHI rules and regulations.
Understand Trends and market evolution.
Collaborate with RM to get the commercial and technical results.
Review and analyze performance reports.
Skills
Data Analysis
Data Simulation Techniques
Create Presentation
Dashboard optimization
Microsoft office advanced (Excel, PowerPoint, etc.
