Health Care Analyst III
About The Position
The Health Care Analyst III develops, documents, and programs in support of 5-Star projects and in-house initiatives. The role conducts in-depth analysis and interpretation of healthcare data, HEDIS reporting, and related work to support high 5-Star ratings. The analyst researches and analyzes Medicare Advantage and healthcare data, produces findings and reports, supports data quality and improvement efforts, and works with internal and external stakeholders to resolve data issues. The position also manages multiple projects, presents findings to analysts and management, and provides training and guidance to lower-level analysts.
Requirements
- Bachelor’s degree or above in mathematics, statistics, biostatistics, computer science, or another quantitative discipline.
- At least 5 years of analytical experience, or at least 4 years of analytical experience in a healthcare or managed care environment.
- Advanced-level proficiency with the MS Office Suite.
- Proficiency with MS SQL queries.
- Excellent technical, interpersonal, written, and oral communication skills.
Nice To Haves
- Experience with HEDIS.
- Experience with medical claims or encounter data.
- Snowflake experience.
- SQL Server Reporting Services experience.
- SQL Server Integration Services experience.
- SAS (Statistical Analysis System) experience.
- Power BI experience.
Responsibilities
- Research and conduct moderate analysis of Medicare Advantage and healthcare data, including membership, provider, claims, authorizations, pharmacy, and financial information.
- Design and produce timely analysis and interpretation of large healthcare datasets related to 5-Star ratings, HEDIS, state-specific programs such as QIP/PIP, state-agency programs such as DHCS or HSAG, and other company initiatives.
- Lead the development, implementation, and documentation of quality assurance processes to ensure reported data is accurate and reliable.
- Conduct data management, quality improvement studies, statistical analysis, and report generation.
- Present findings to higher-level analysts and HCI mid- and senior management.
- Perform moderate to complex analysis and interpret organizational data, including data mining, verification, mapping, scrubbing, and scraping.
- Develop actionable and supportable findings within tight deadlines and changing requirements.
- Conduct investigative research to uncover root causes, interpret results, identify trends, and recommend action.
- Work with internal and external stakeholders to troubleshoot and correct data anomalies.
- Manage multiple moderate to complex projects concurrently and complete them accurately within specified timelines by prioritizing work and communicating workload issues.
- Lead training and provide guidance and support to lower-level analysts.
- Serve as a point of contact for internal and external customers, resolve routine and complex questions and problems, and escalate the most complex issues as needed.
- Proactively monitor and clarify technical responses to business requirements on Medicare-related projects to ensure business needs are understood.
- Support the achievement of SCAN’s Vision and Goals.
- Perform other duties as assigned.
Benefits
- Annual employee bonus program
- Robust wellness program
- Generous paid time off (PTO)
- 11 paid holidays per year, one floating holiday, and one birthday holiday
- 401(k) retirement savings plan with employer match
- Employee recognition program
- Tuition reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
