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The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. Maintains in-depth knowledge of health plan operations, including claims processing, utilization management, quality improvement activities and pay for performance programs.

YEAR

Overview:
The Senior Healthcare Data Analyst I contributes to the overall success of the organization by developing analytic solutions that support activities related to health services utilization management, care coordination, quality improvement and population health. Through analyzing patient claims, member enrollment, and other data, the Senior Healthcare Data Analyst participates in identifying progress, performance and opportunities for improvement on programs, quality of care, patient experience, and other metrics. This position requires a thorough understanding of healthcare data and workflows, combined with an extensive experience working with large data sets, conducting data analysis, including standard statistical software (SAS), and creating reports using Tableau.

Responsibilities:
<ul><li>Works collaboratively with business partners, other analysts, and IT to gather and integrate data from disparate sources.</li><li>Responds to ad hoc data requests from business units and leadership</li><li>Assists in design and development of data collection strategies, aggregation, analysis, and reporting to ensure data integrity and enhance information value.</li><li>Participates in design and interpretation of data analyses; provides recommendations for improvement of data quality and reporting.</li><li>Helps build, manage, and/or enhance predictive models</li><li>Assesses reporting and automation requirements and develops appropriate solutions.</li><li>Maintains in-depth knowledge of health plan operations, including claims processing, utilization management, quality improvement activities and pay for performance programs.</li><li>Critically analyzes data, draws conclusions and effectively articulates results.</li><li>Presents data and conclusions to non-technical audience; uses data visualizations and summaries to highlight key findings.</li><li>Creates and maintains thorough and consistent documentation of programs used to create reports.</li><li>Manages and prioritizes workload while meeting deliverables and expectations.</li><li>Works autonomously and collaboratively with report requestors, providing guidance to define report requirements and validate results.</li><li>Works collaboratively across departments to understand and meet the organization’s analytic needs.</li></ul> SECONDARY DUTIES AND RESPONSIBILITIES<ul><li>Performs other assigned or needed activities required to assure success of the organization.</li><li>Participates in special projects as needed.</li><li>Performs other duties as assigned.</li></ul>General Traits<ul><li>Passionate about data, willing to acquire new skills and knowledge, flexible, self-motivated, and very curious.</li><li>Creative problem-solver, critical thinker, independent worker, data-driven mentality.</li><li>Communicates clearly and directly, relates well to others, engages people, provides and seeks feedback, articulates clearly, actively listens.</li></ul>

Qualifications:
<table style="border-collapse:collapse"><tbody><tr><td style="padding:0in 5.4pt;border:#000000;width:113.4pt">Education and Experience</td><td style="padding:0in 5.4pt;border:#000000;width:365.4pt">Bachelor’s degree with concentration in health informatics, health administration, public health, computing, epidemiology, statistics or related field, Master’s degree preferred. Minimum four (4) years of experience in data analysis and reporting. Knowledge of major health plan operations: healthcare claims processing, membership, provider, and benefits; or equivalent combination of education and experience. Excellent knowledge of data collection, analysis, statistics and data presentation with experience in data mining techniques and procedures. Experience using statistical packages for analyzing large data sets, SAS and/or SQL a plus. Experience working with administrative data, ideally health care data (Medicaid data a plus). Understanding of health data formats including claims, lab and pharmacy. Knowledge of clinical coding systems (e.g., ICD9, ICD10, CPT).   </td></tr><tr><td style="padding:0in 5.4pt;border:#000000;width:113.4pt">Special Skills, Licenses andCertifications</td><td style="padding:0in 5.4pt;border:#000000;width:365.4pt">Proficiency in inferential and predictive statistical analysis. MS Office, Excel, SQL, SAS, Tableau. Ability to present complex information in an understandable and compelling manner.  </td></tr><tr><td style="padding:0in 5.4pt;border:#000000;width:113.4pt">Performance Based Competencies</td><td style="padding:0in 5.4pt;border:#000000;width:365.4pt">Ability to quickly acquire in-depth knowledge of various systems related to claims processing, membership, provider, and benefits at Partnership. Strong written and oral communication skills with ability to interpret and understand technical requirements. Excellent analytical skills to troubleshoot and resolve data issues. Must be highly organized and proficient at multi-tasking. Must be willing and able to provide gracious assistance to users, providers, and other constituents of Partnership.  </td></tr><tr><td style="padding:0in 5.4pt;border:#000000;width:113.4pt">Work Environment And Physical Demands</td><td style="padding:0in 5.4pt;border:#000000;width:365.4pt">More than 50% of work time is spent at a video display terminal. </td></tr></tbody></table>  All HealthPlan employees are expected to: <ul><li style="color:#000000">Provide the highest possible level of service to clients;</li><li style="color:#000000;font-family:'arial' , sans-serif;font-size:11pt">Promote teamwork and cooperative effort among employees;</li><li style="color:#000000;font-family:'arial' , sans-serif;font-size:11pt">Maintain safe practices; and</li><li style="color:#000000;font-family:'arial' , sans-serif;font-size:11pt">Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.</li></ul>HIRING RANGE: $103,059.95 - $133,977.94 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Partnership HealthPlan of California

Senior Health Data Analyst I

Analysis Skills

Automation

Claims Processing

Clinical Information Systems

Communication Skills

Customer Support/Service

Data Analysis

Data Collection

Data Formats

Data Mining

Data Quality

Data Sets

Data Visualization

Documentation

Epidemiology

Establish Priorities

Health Informatics

Health Plan

Healthcare

Healthcare Administration

ICD-10

ICD-9

Identify Issues

Leadership

Medicaid

Medical Coding

Metrics

Microsoft Excel

Microsoft Office

Multitasking

Operations Planning

Organizational Skills

Patient Care

People Management

Pharmacy

Predictive Modeling

Presentation/Verbal Skills

Problem Solving Skills

Public Health

Quality Management

Quality of Care

Reporting Skills

Requirements Management

Requirements Validation/Verification

SQL (Structured Query Language)

Statistical Analysis System (SAS)

Statistics

Strategic Planning

Tableau

Utilization Management

Writing Skills

[AW]-iCims

This role designs and executes analytic strategies that support quality improvement, research, care management, and analytic services—helping stakeholders use data effectively to improve health care outcomes and measure success. Senior Healthcare Data AnalystLocation: RemoteEmployment Type: Full-TimeOverviewWe are seeking a Senior Healthcare Data Analyst to lead advanced analytics in a multidisciplinary environment.

Why Comagine Health?Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years.We are leaders in assisting front-line providers and engaging health care partners to improve care delivery and patient outcomes.Our talented remote workforce spans the country and plays a vital role in our success. We go beyond merely providing a remote work option; we support and embrace it. We offer opportunities to make a difference from anywhere in the U.S. and enjoy better work-life balance. An annual stipend gives you the freedom to enhance your workspace with options that suit your needs.We believe in an environment that allows you to thrive both personally and professionally. That's why we offer benefits that include:Medical, dental and vision insurancePaid time off for vacation, illness and volunteeringRetirement savings plan with employer contributionAdoption financial assistancePaid parental leaveAnd much more!Senior Healthcare Data AnalystLocation: RemoteEmployment Type: Full-TimeOverviewWe are seeking a Senior Healthcare Data Analyst to lead advanced analytics in a multidisciplinary environment. This role designs and executes analytic strategies that support quality improvement, research, care management, and analytic services—helping stakeholders use data effectively to improve health care outcomes and measure success.The ideal candidate brings deep technical expertise, strong communication skills, and the ability to deliver clinically, scientifically, and statistically sound analyses on time.Advanced coding proficiency in SAS, SQL, R, Python, or similar languages is a must.Key ResponsibilitiesDesign and lead analytics for quality improvement, research, and care management projectsDevelop and maintain dashboards, reports, and ad hoc analysesServe as a subject matter expert on healthcare data interpretation and useApply advanced statistical methods and programming solutionsStandardize analytic and reporting processes and documentationTranslate complex data into clear insights for leadership and stakeholdersMentor and provide guidance to less-experienced analystsPartner with IT and data governance teams to ensure data integrity and complianceQualificationsBA/BS in epidemiology, statistics, mathematics, computer science, social sciences, or related field (or equivalent experience)Master's degree preferred8+ years of healthcare-related data analysis or research experienceAdvanced coding proficiency in SAS, SQL, R, Python, or similar languagesExperience with large datasets, relational databases, and data visualization tools (Tableau, Power BI, or similar)Strong knowledge of statistics/biostatistics and analytic methodologiesExcellent communication, problem-solving, and attention to detailPreferredProject management or supervisory experienceStudy design experienceAdditional InformationMinimal travel requiredCompetitive compensation and comprehensive benefits packageEqual Opportunity EmployerWe are committed to building a diverse and inclusive workplace and encourage candidates from all backgrounds to apply.Physical Requirements & Work EnvironmentThis position is primarily remote and performed in a home-based setting, requiring reliable internet access and a workspace free from significant distractions. The role involves frequent use of computers, phones, and virtual communication tools. Employees must be able to sit for extended periods, communicate effectively. Some positions may require operating a motor vehicle for business purposes; in such cases, employees must maintain a valid driver's license and meet the organization's driving eligibility requirements. Occasional travel may be required for meetings, training, or other work-related events. Reasonable accommodations will be provided to enable individuals with disabilities to perform essential functions.Equal Employment Opportunity, including veterans and individuals with disabilities.PI284193244#J-18808-Ljbffr

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Senior Health Data Analyst I Partnership HealthPlan of California

Sr. Healthcare Data Analyst Comagine Health

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