Senior Healthcare Data Analyst

Commonwealth of Massachusetts • Quincy, MA

1d • Hybrid

About The Position

The Massachusetts Office of Medicaid (MassHealth) is seeking a highly motivated, collaborative, and experienced analytics professional to serve as a Senior Healthcare Data Analyst within the MassHealth Analytics Department. This position provides advanced analytical and technical support to MassHealth's Program Integrity (PI) team, helping safeguard public resources, strengthen program accountability, and support efforts to identify fraud, waste, and abuse (FWA). The successful candidate will analyze complex healthcare data, develop advanced analytical methodologies, evaluate provider billing and utilization patterns, and translate sophisticated analyses into actionable insights that inform program integrity activities, policy, and operations. Reporting to the Deputy Director of Analytics, the Senior Healthcare Data Analyst will serve as a technical subject matter expert and work collaboratively with Program Integrity staff, MassHealth program teams, data warehouse staff, vendors, and other internal and external stakeholders. The position will develop and deploy advanced SQL queries and analytical data models, analyze large eligibility, enrollment, and claims datasets, identify potential overpayments and indicators of FWA, and support audits and investigations. The Senior Healthcare Data Analyst will independently manage complex analytical projects, oversee key analytical assets and code, provide guidance to junior analysts, and help ensure that data and analytical methodologies are used effectively to support MassHealth's programmatic and operational objectives.

Requirements

• Minimum Entrance Requirements: Applicants must have (A) at least three (3) years of full-time or equivalent part-time professional or practical experience in the field of information technology data analytics, or (B) any equivalent combination of the required experience and the substitutions below.
• An Associate’s degree in a related field may substitute for one (1) year of the required experience.
• A Bachelor’s degree or higher in a related field may substitute for two (2) years of the required experience.
• A Master’s degree or higher in a related field may substitute for the required experience.

Nice To Haves

• Experience working with healthcare claims, eligibility, enrollment, provider, utilization, payment, or other healthcare administrative data.
• Experience supporting Program Integrity, fraud, waste, and abuse detection, payment integrity, provider auditing, claims analysis, or related healthcare oversight activities.
• Advanced proficiency in SQL and experience analyzing large and complex datasets containing millions of records.
• Experience developing analytical data models, reusable datasets, code, and other technical assets.
• Experience with data visualization and business intelligence tools such as Tableau.
• Demonstrated experience independently conducting complex analyses from development of the analytical approach through execution, quality assurance, interpretation, and presentation of results.
• Ability to translate complex analytical findings into clear, actionable information for technical and nontechnical stakeholders.
• Experience serving as a technical subject matter expert, collaborating across functional teams, and providing guidance or support to junior analysts.
• Familiarity with AI-assisted development tools, including coding copilots, AI agents, or similar technologies, and the ability to apply them effectively and responsibly within analytics workflows.
• Strong critical-thinking, problem-solving, data-validation, organizational, and communication skills, with the ability to manage multiple priorities independently.
• Knowledge of Medicaid, MassHealth, Program Integrity, or the Massachusetts healthcare industry is highly desirable.

Responsibilities

• Analyze, design, and develop complex analytical data models using large healthcare datasets, including eligibility, enrollment, claims, provider, utilization, and payment data.
• Develop advanced SQL queries and analytical methodologies to identify trends, cost and utilization drivers, provider billing patterns, potential overpayments, and indicators of fraud, waste, and abuse (FWA).
• Lead complex analytical projects from initial scoping through execution, quality assurance, interpretation, and presentation of results.
• Partner with Program Integrity staff and other stakeholders to define business and analytical needs and translate findings into actionable insights that support audits, investigations, policymaking, and program operations.
• Collaborate with data warehouse and technical teams to develop data models, analytical assets, and reusable code that support effective use of data across the agency.
• Serve as a technical subject matter expert to vendors performing analytical work, including providing guidance on data use, methodologies, deliverables, and initiatives involving artificial intelligence.
• Conduct data profiling, validation, testing, and quality control to ensure the accuracy and reliability of analytical products.
• Oversee the development and maintenance of key analytical assets and provide technical guidance, training, and support to junior analysts.
• Lead and participate in cross-functional initiatives while independently managing multiple projects, priorities, and deliverables.
• Perform other duties as assigned.

Benefits

• Comprehensive Benefits
• outstanding suite of employee benefits that add to the overall value of your compensation package
• work experience that supports you, your loved ones, and your future

What This Job Offers

• Job Type: Full-time
• Career Level: Senior