Business Intelligence Analyst III -Quality

About the role

We are looking for a Business Intelligence Analyst III - Quality who can help shape our vision and support our mission. This position serves as the primary point of contact for department data requests, working with multiple departments to gather information and represent the Quality team in meetings where new data requests are reviewed or requested.

As an integrated line of business team member, you will ensure information needs are understood, complete specifications are identified, and appropriate analysis, research, reports, or other support are provided to address those needs. You will analyze and document requirements, design and document customer reporting and analytic requests, and transform complex Business Intelligence requests into useful products with actionable outcomes.

Responsibilities

• Serve as the primary point of contact for department data requests and represent the Quality team in relevant meetings.
• Gather and analyze requirements through research, data gathering, and brainstorming activities.
• Design and document customer reporting and analytic requests by defining, creating, evaluating, and selecting alternatives aligned with strategic plans, business problems, and operational efficiency.
• Develop and update dynamic reports in PowerBI and SSRS, presenting results to Senior Management.
• Identify actionable issues through data interpretation and research, providing summaries of trends and observations.
• Apply advanced data analysis and statistical techniques to answer complex data questions and initiatives.
• Validate output to ensure it meets Line of Business needs and partner with directors to dig deeper into findings.
• Develop new tools and system enhancements, troubleshoot data issues, and resolve data quality problems.
• Participate in training programs and maintain an individual training/education strategy with your supervisor.
• Contribute to the Company’s Strategic Plan as identified by Department management.

Requirements

• Bachelor’s degree in a health care-related area, statistics, or computer systems; equivalent combination of experience and education may substitute with a preference for four years of progressive relevant work experience.
• Minimum of five years’ experience in a healthcare data-related field with at least four years of SQL experience.
• Significant experience with advanced data reporting and analysis methods, data management, and query tools such as Toad, SSMS, SSRS, Power BI, Business Objects, Tableau, Python, or similar tools.
• Exposure to value-based care analytics, Pay-for-Performance, Shared Savings performance tracking, HEDIS Measures, and financial projections modeling is a plus.

Skills

• Expert understanding of health benefits, medical terminology, medical procedures, and the managed care industry, including CPT, ICD, and other coding systems.
• Strong analytical, problem-solving, and research skills with the ability to define, evaluate, and select solutions to business problems.
• Ability to pivot and respond quickly to ad hoc analyses of claims expense, membership, and provider performance.
• Excellent written and verbal communication skills, with the ability to interpret complex data and translate it into actionable insights.
• Strong interpersonal and teamwork skills, with good organizational and time management abilities.
• Proficiency in MS-Office applications (Excel, Access, Word, PowerPoint).
• Familiarity with Medicaid quality programs, health plan performance metrics, and NCQA standards is preferred.
• Ability to translate quality program requirements into dashboard specifications and analytic products.
• Experience working with cross-functional teams including quality, finance, and operations.
• Understanding of intervention effectiveness evaluation methods and gap closure analytics.

Benefits

• Medical, dental, and vision insurance starting the first day of the month following your start date.
• Supplemental insurance options such as critical illness and accidental injury.
• Health care and dependent care flexible spending accounts.
• Employer-paid basic life insurance and AD&D (employee, spouse, and dependent).
• Short-term and long-term disability coverage.
• Voluntary life insurance (employee, spouse, dependent).
• Paid time off (PTO) and floating holidays, plus nine company-paid holidays.
• 401K retirement plan.
• Tuition reimbursement (based on eligibility).
• Annual bonus program (based on eligibility, requirements, and performance).
• Hybrid work environment (in-office and remote).
• Employee Assistance Program.
• Language pay stipend.

Pay

The compensation for this position is $94,600.00 - $126,200.00 annually. The salary offered will be determined based on qualifications, departmental budget, internal salary equity, and market information.

Schedule

This position follows a hybrid work model, blending in-office and remote work. We are unable to support out-of-state employees at this time.