Sr. Healthcare Informatics Analyst (Medicare Advantage)

Glint Tech Solutions LLC • Alabama, Alabama, United States, AL

17h • Remote

About The Position

A leading healthcare payer client is seeking a Senior Healthcare Informatics Analyst who will independently provide analytics to understand and improve how healthcare is valued, utilized, and provided. This role develops analytic attributes related to patient-level health utilization/outcomes, provider performance measures, risk-adjusted revenue optimization, medical cost management, and patient/provider engagement behavior, collaborating with business areas and IT to lead problem solving, solution development, and strategic planning.

Requirements

• Healthcare experience required, with Medicare Advantage trend analysis experience
• Bachelor's degree in healthcare administration, statistics, economics, analytics, or computer science (4 years of relevant experience may substitute; Master's preferred)
• 4+ years of healthcare, analytics, IT, or management consulting experience
• Strong critical thinking, analytical, and problem-solving skills
• Experience building predictive models
• Strong knowledge of SQL, SAS, R, Python, Tableau, or similar query/analytic/visualization tools
• Basic knowledge of the U.S. healthcare delivery system in a payer or provider setting

Nice To Haves

• Strong knowledge of outcome research design and controlled study design
• Advanced knowledge of SAS, including Enterprise Miner
• Strong understanding of provider payment methodologies, population health management, and risk adjustment
• Strong understanding of clinical groupers, including episode and risk groupers (DRG, APC, ETG, MEG, DxCG, HCC)
• Strong understanding of quality metrics (HEDIS, AHRQ)
• Knowledge of commercial risk optimization and MA risk optimization

Responsibilities

• Independently provide analytics to understand and improve how healthcare is valued, utilized, and provided
• Develop analytic attributes pertaining to patient-level health utilization/outcomes, provider performance measures, and risk-adjusted revenue optimization
• Support medical cost management and analysis of patient/provider engagement behavior attributes
• Lead problem solving, solution development, and strategic planning in collaboration with other business areas and IT
• Ensure compliance with all laws and regulations associated with duties and responsibilities

What This Job Offers

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