The Healthcare Data Analyst is responsible for analytics, financial analysis and claims auditing. This candidate will reside within the Analytics and Reporting department and will work closely with other members of the Clinical, Medical and Network teams to design and analyze operational and claims data. This person will also present results to internal stakeholders, existing and future clients. Additionally, the ideal candidate will serve as a leader in defining and prioritizing the strategic and tactical tasks surrounding future data intelligence.
Essential Functions
Analyze business intelligence data to inform business and product decisions, blending historical results, available industry reports, purchased sources and public information as input to analyses
Identify areas for increased clinical focus and review/assess associated action plans
Maintain provider rate information and assess overall cost impact of proposed changes
Support claims audit processes and procedures to ensure the fidelity of claims processing
Conduct on-going refinement of the risk stratification surrounding claims processing
Design, develop, interpret and present key internal business operational metrics reporting, serving as an ongoing voice for improving and increasing data intelligence leading to operational improvements
Contribute to the identification and prioritization of improved reporting processes and procedures
Provide on-going analysis and recommendations for improvement of operations and clinical interventions
Provide direction in preparing and/or reviewing reports for publication.
Assist with planning tactical goals to achieve major improvements in data analytics capabilities over time
Adheres to our Mission Statement, Core Values, Code of Business Conduct and Compliance Program
Complies with all Federal and applicable State laws and policies regarding privacy, confidentiality and security of health information and other designated information
EDUCATION & EXPERIENCE
Required
Bachelor's Degree in Computer ScienceInformation Technology, MathematicsStatistics, Business or other relevant field
At least three years of experience analyzing healthcare data. Preferably from a payer setting
Understanding business impact is critical to improving our internal processes and seeking to maximize the ROI
Prior experience producing reporting and providing analysis to organizational leadership
Ability to work in a fast-paced, collaborative team environment
Self-starter and may mentor/train other department members
Strong communications skills
Ability to work well both independently and as part of a multi-functional team, including technical, financial, administrative and clinical associates
Strong knowledge of analytic, technical and reporting tools. Tableau and SQL experience preferred
Advanced proficiency with Microsoft Word, Excel and PowerPoint production.