About The Position
Under guidance, performs data analytics activities related to complex business problems and issues to provide insights to decision-makers. Provides analytical support for internal project teams and external client engagements focused on claims data, healthcare, pharmaceutical, and payer data. The role requires experience working with healthcare claims adjudication data, identifying trends, validating datasets, and supporting business decisions through claims data-driven analysis.
Requirements
- Experience working with healthcare claims adjudication datasets, including paid claims, rejected claims, reversed claims, and remittance claims.
- Strong analytical and problem-solving skills with the ability to identify trends, patterns, and anomalies within large datasets.
- Strong verbal and written communication skills.
- Effective time management, organizational, and prioritization skills.
- Ability to work collaboratively across teams and functions to achieve organizational goals.
- Proficiency in Microsoft Office applications, including: Excel, PowerPoint, Word, Access.
- Knowledge of healthcare, pharmaceutical, payer, provider, and reimbursement data environments.
- Knowledge of healthcare analytics methodologies, tools, and techniques.
- Understanding of the healthcare and pharmaceutical marketplace, including patient access and reimbursement dynamics.
Nice To Haves
- Bachelor's degree in Analytics, Statistics, Business, Health Informatics, Life Sciences, or a related field.
- 1-3 years of professional experience in a pharmacy, claims adjudication, or Patient Support Program (PSP) environment.
- Experience working with medical claims data, pharmacy claims data, payer data, healthcare datasets.
- Understanding of healthcare claims adjudication processes, including: Reimbursement methodologies, Prior authorization processes, Denials management, Payer operations.
- Experience with SQL, data validation, reporting, and data quality management.
- Experience analyzing claims adjudication data, market access data, payer data, reimbursement data, pharmacy claims data, medical claims data.
- Exposure to healthcare analytics, patient-level longitudinal datasets, pharmaceutical commercial analytics.
- Experience supporting client-facing analytics projects within: Healthcare, Pharmaceutical, Managed care, Life sciences organizations.
- Familiarity with IQVIA healthcare data assets and healthcare claims data structures is highly desirable.
Responsibilities
- Perform quantitative and qualitative analyses to support the development of solutions for internal and external client project teams utilizing claims adjudication data.
- Conduct claims adjudication analytics by analyzing healthcare, pharmacy, and medical claims data, including: Paid claims, Rejected claims, Reversed claims, Reimbursement outcomes, Denial patterns, Patient access trends.
- Identify, analyze, and interpret trends and patterns within large healthcare and pharmaceutical market access datasets to provide actionable business insights.
- Support the analysis of payer, reimbursement, utilization management, and market access data to evaluate business performance and identify patient access barriers.
- Create specifications for reports, dashboards, and analytical outputs based on business requirements and available data elements.
- Produce datasets, reports, and ad hoc analyses using IQVIA tools, databases, and reporting platforms.
- Verify data accuracy, completeness, consistency, and adherence to established quality standards.
- Manipulate, transform, and validate data to optimize analytical outcomes and improve reporting efficiency.
- Perform audits of own work and that of others to ensure compliance with established procedures and data quality requirements.
- Utilize standalone data systems and enterprise-wide platforms to support: Inquiry resolution, Claims validation, Data quality reviews, Adjudication analysis, Trend reporting.
- Collaborate with cross-functional teams to support client deliverables, operational reporting, and healthcare analytics initiatives.
- Present findings, insights, and recommendations to stakeholders in a clear and concise manner.
Benefits
- Health and wellness benefits
- Other benefits
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
