Data Analyst III Healthcare Analytics

Centene Corporation

About The Position

Centene is seeking a Data Analyst III for Healthcare Analytics to analyze integrated and extensive datasets to extract value, directly impacting and influencing business decisions. This role involves collaborating with key business stakeholders to identify areas of value, develop solutions, and deliver insights aimed at reducing the overall cost of care for members and improving their clinical outcomes. Specifically, this Data Analyst III will support Medicare cost of care analytics by analyzing claims and cost trends, identifying outliers, and drilling into drivers such as diagnosis codes and payment methodologies (DRG, EAPG, APC). The ideal candidate is technically strong in SQL, Power BI, and Excel, highly curious, asks strong clarifying questions, and can independently translate complex claims data into clear, executive-ready insights and data stories for senior Medicare leadership. The position is crucial for transforming the health of Centene's 28 million members.

Requirements

Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience
4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience
Working knowledge of SQL/querying languages
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

Nice To Haves

Master's degree
Healthcare analytics experience
Knowledge of programmatic coding languages such as Python and R
Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis
Knowledge of modern business intelligence and visualization tools including Microsoft PowerBI
Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation
Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare

Responsibilities

Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions
Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes
Support Medicare cost of care analytics by analyzing claims and cost trends, identifying outliers, and drilling into drivers such as diagnosis codes and payment methodologies (DRG, EAPG, APC)
Interpret and analyze data from multiple sources including claims, provider, member, and encounters data
Identify and assess the business impact of trends
Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools
Contribute to the planning and execution of large-scale projects with limited direction from leadership
Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation
Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers
Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment
Demonstrate a sense of ownership over projects and ask probing questions to understand the business value of tasks
Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products
Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners
Independently engage with customers and business partners to gather requirements and validate results
Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required
Provide technical guidance to junior analysts