Location/Schedule: This is an on-site position in Orange County, CA, Monday through Friday, from 9:00 AM to 6:00 PM.
Description:
Impresiv Health is seeking an experienced Sr. Informatics Analyst to join a growing Medicare Advantage Prescription Drug Plan (MAPD) healthcare organization dedicated to improving healthcare accessibility, quality, and outcomes for underserved communities.
The Sr. Informatics Analyst will lead the management, organization, integration, and analysis of healthcare data using industry-standard technologies and solutions. This individual will work closely with Operations, Clinical, and IT leadership to identify trends, develop actionable insights, and support data-driven decision-making.
The role requires a strong understanding of healthcare operations, data structures, and business applications, with the ability to translate complex data requirements into queries, data models, visualizations, algorithms, and reports that improve healthcare quality and reduce costs.
This position reports directly to the Chief Information Officer (CIO) and collaborates closely with the Chief Medical Officer (CMO), Chief Operations Officer (COO), and other executive leadership.
What You Will Do:
- Lead the implementation of clinical decision support tools and analytics to assist leadership in making evidence-based decisions, developing clinical guidelines, and advancing best practices.
- Develop analytical trending reports to identify patterns, communicate findings, and recommend improvements.
- Design and build healthcare data models that support analytical and decision-support initiatives by collecting and integrating information from disparate internal and external sources.
- Develop complex SQL queries, stored procedures, functions, algorithms, reports, and visualizations to support healthcare analytics and operational decision-making.
- Analyze healthcare operations, utilization, quality, and financial data to identify opportunities to improve care quality and reduce health plan costs.
- Lead data collection, integration, analysis, and reporting efforts across clinical, operational, and financial systems.
- Develop and maintain documentation of underlying data structures, definitions, and appropriate business uses.
- Translate business and end-user information requirements into analytical solutions that deliver meaningful insights.
- Present findings and recommendations to Operations, Clinical, IT, and executive leadership.
- Provide oversight and quality assurance of Informatics team deliverables.
- Mentor, train, and advise Informatics team members on systems, databases, analytics tools, and best practices.
- Support special projects as assigned.
- Travel as required.
You Will Be Successful If:
- You can independently develop advanced T-SQL queries, stored procedures, and functions to support complex healthcare reporting and analytics.
- You understand relational databases, data marts, data cubes, and healthcare data modeling principles.
- You can integrate information from multiple healthcare data sources and transform complex datasets into accurate, actionable insights.
- You can identify trends and recommend practical improvements that enhance healthcare quality and reduce costs.
- You demonstrate strong analytical skills and maintain accuracy and attention to detail when working with large volumes of data.
- You communicate technical findings clearly to clinical, operational, and executive stakeholders.
- You effectively prioritize competing assignments, promote teamwork, and support fact-based decision-making.
- You demonstrate strong critical listening, problem-solving, and communication skills.
- You work independently while collaborating effectively with cross-functional teams.
- You can provide technical guidance, mentorship, and quality oversight to other analysts.
- You are adaptable, resilient, and comfortable working in a fast-paced, growing healthcare organization with evolving priorities.
What You Will Bring:
- 3+ years of experience with T-SQL and SAS, relational databases, and/or commercial analytics tools, such as Power BI, SQL Server Reporting Services (SSRS), Crystal Reports, or similar technologies.
- Extensive experience using T-SQL to develop complex queries, stored procedures, and functions.
- Experience working with relational databases and commercial analytics solutions, including building data marts, data cubes, and data visualizations.
- Strong analytical skills with the ability to collect, organize, analyze, and communicate significant volumes of information accurately.
- Proficiency in Microsoft Office applications, including Excel, PowerPoint, Project, Outlook, Word, and Visio.
- Knowledge of medical terminology and healthcare coding systems, including ICD-10, CPT, DRG, NDC, HCPCS, modifiers, and revenue codes.
- Knowledge of data contained within HIPAA transactions, including 270/271, 834, 835, and 837.
- Ability to manage and prioritize multiple assignments while promoting teamwork and data-driven decision-making.
- Strong communication, critical listening, and problem-solving skills.
- Ability to work independently and collaboratively in a team environment.
- Ability to thrive in a fast-paced, start-up environment and adapt to changing priorities.
- Willingness and ability to travel as required.
Preferred Qualifications:
- Bachelor's degree in Healthcare Informatics, Computer Science, Statistics, Mathematics, or a related field.
- Experience working within a Medicare Advantage or Medicare Advantage Prescription Drug Plan (MAPD) organization.
- Experience with health plan contracting or risk and capitation payment models, including commissions and capitation data.
- Knowledge of CMS-1500 and UB-04 claim forms, including claim versus encounter data processing in managed care environments.
- Experience with healthcare data quality, governance, and/or audits involving HEDIS, Medicare Star Ratings, and Risk Adjustment Factor (RAF) data.
- Experience with health plan benefit interpretation.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
That’s Impresiv!