The position requires broad analytical and statistical skills to mitigate potential risk factors that involve healthcare stakeholders and their associated business models. Such risk factors include demographical, morbidity shifts, medicine cost inflation and utilisation changes as it relates to but is not limited to Fraud waste and abuse identification and risk mitigation. After analysing these factors, decisions, suggestions and implementation of solutions on how to safeguard these organizations against identified risks, and results reported back to the stakeholders.
RESPONSIBILITIES/ KEY PERFORMANCE AREAS:
MODELING DESIGN, DEVELOPMENT AND IMPLEMENTATION
Work with the respective stakeholders to deliver the required capability which involves the following aspects:
- Analysis of the requirements
- Design to ensure a flexible and automated solution
- Testing of the solution with required feedback to the developer ensuring delivery to requirements at the required quality
- Implementation and training to the respective team members & Clients as applicable
- Documentation management as appropriate
- Statistical and financial modeling
- Risk identification and mitigation as it relates to but not limited to Fraud waste and abuse.
DATA WAREHOUSE DESIGN
- Form part of the data warehouse design team with the Business Analytics analyst, General Manager, ETL data warehouse specialist(s) wrt projects /products as identified
- Solution Analysis and underlying procedures, database design and logic.
BI PRODUCT DEVELOPMENT AND ENHANCEMENT
- With the BI Systems Analyst form part of the BI product design team consulting stakeholders with regards to technical & statistical view of product development for identifying and mitigation of business risk.
- Demonstrate modeling capability/functionality to stakeholders.
- Identify and implement mitigation strategies as it relates to business and industry risks.
CONSULTING/MENTORING ROLE
- Consult, mentor and train various members in the BI department with regards to coding / reporting involving the following
- Financial field application & financial calculations
- Financial modeling applications
- Application of Statistical/Actuarial methodologies
- Fraud waste and Abuse methodologies
SPECIAL PROJECTS & AD HOC REQUESTS
- Assignment with regards to special projects / adhoc requests from time to time.
INTERNAL RELATIONSHIPS
- BI department
- General Manager
- BI developers
- Cognos: BI architect/technical lead
- SQL: BI architect/technical lead
- Qlikview/Qlik Sense developers
- Business Users
- Project Managers
- Functional Managers
- IT Development Managers
- IT Implementation Manager
- EXCO
- Sub Project Managers
- Operational managers
EXTERNAL RELATIONSHIPS
- Industry Partners/software suppliers.
- Outsourced development where relevant – contracted parties.
- Scheme Clients
- Providers
- Forensic Partners
EDUCATIONAL REQUIREMENTS
- Tertiary qualification e.g. B.Sc/B.Com Actuarial Science or Financial Mathematics or Mathematical Statistics
- BI experience
- Qlik suite of tools essential / Cognos experience will be beneficial
BACKGROUND EXPERIENCE & TECHNICAL SKILL REQUIREMENTS
Analytics – a min of 5 years’ experience
- Data Modelling
- Statistical trend and correlation Analysis
- Outlier identification
- Report writing
- Automation solutions
- Neural Network experience will be beneficial.
- Fraud, Waste and abuse experience as it relates to healthcare will be beneficial.
SQL – a min of 3 years’ experience
- Microsoft SQL Server
- Proficient in writing queries and stored procedures for reporting & testing purposes
The following technical skills will be advantageous
- Microsoft SQL Server 2019 SSIS, including active X-scripting (VB script)
- Microsoft SQL Server 2019 Transact-SQL & stored procedures
- Ralph Kimball Data Warehouse star schema methodology
WORK REQUIREMENTS
- The Company is based in Sunninghill Park, Sandton.
- The hours of work: From Monday to Friday, 8am to5 pm.
THE EMPLOYMENT EQUITY APPROACH OF UNIVERSAL HEALTHCARE BROADLY AIMS TO:
- Foster diversity in the workplace;
- Promote equal opportunity and fair treatment in employment through the elimination of all forms of unfair discrimination.
Thank you for your interest in working for Universal Healthcare. Kindly note that your application will be reviewed in accordance to the job requirements and the Company will select suitable candidates with cognisance of its Employment Equity policy. Should no response be received within 30 working days from your date of submission, please consider your application unsuccessful for this position, your resume will remain active in our database should you be suitable for positions in future.
Desired Skills:
- Data Analysis
- Data Integrity
- Communication (written and verbal)
- Attention to detail
- Building Positive Working Relationships
- Problem Solving And Decision Making
- Quality orientation
- Ability to work independently
About The Employer:
Universal Healthcare has established itself as a leader in providing evidence-based, integrated healthcare services in the areas of medical scheme administration, healthcare insurance, healthcare management, corporate and occupational health and wellness, and integrated wellness-based loyalty programmes.
We create access to healthcare for the people of South Africa through medical schemes, customised corporate health products, health insurance, employee wellness programmes, managed care, a network of healthcare professionals, gap cover and much more.
Our Vision
“To be a top performing, world class healthcare and technology group, respected for excellence by providing access to innovative, evidence-based solutions with a caring approach.”
Employer & Job Benefits:
- Medical Aid
- Gap Cover
- Pension Fund
- Group Life and Permanent Health Insurance
- 360 Degrees Loyalty Programme
- Funeral Cover