Clinical Operations Analyst

About the role

GEHA is a nonprofit member association that provides health and dental benefits to millions of federal employees, retirees, military retirees, and their families. The Clinical Operations Analyst plays a pivotal role in analyzing, developing, and delivering comprehensive clinical reports that provide actionable insights to senior leadership. This position requires a strong background in healthcare data analysis, a deep understanding of clinical operations, and the ability to translate complex data into meaningful, actionable information. The role supports executive reporting and clinical-specific utilization reporting needs for all stakeholders within GEHA, including Clinical Quality, Population Health, Dental, Pharmacy, Medical Management, and Health & Well-being.

The individual will work in close partnership with the Director of Medical Management to meet the needs of the Clinical Operations Division.

Responsibilities

• Gather, organize, and analyze clinical data from various sources within GEHA.
• Develop comprehensive reports and presentations for senior leadership, providing insights into clinical operations, outcomes, and performance metrics.
• Evaluate clinical performance indicators, identifying trends, patterns, and areas for improvement.
• Collaborate with clinical teams to understand operational challenges and opportunities for enhancement.
• Review and assess dashboards and metrics that offer real-time insights into clinical performance and outcomes for the full clinical operations division.
• Develop key performance indicators (KPIs) and benchmarks to track progress and support data-driven decision-making.
• Work closely with Data & Analytics and other GEHA departments to ensure data integrity, standardization, and accuracy.
• Collaborate with stakeholders to identify reporting requirements and implement solutions to meet their needs.
• Identify areas for process improvement, efficiency, and quality enhancement within clinical operations.
• Recommend strategies for optimization based on data-driven insights and industry best practices.
• Prepare clear and concise documentation of methodologies, findings, and recommendations.
• Deliver presentations to senior leadership, effectively communicating complex data in an understandable manner.

Requirements

• Bachelor’s degree in healthcare management, data science, statistics, or a related field.
• Proven experience (3+ years) in healthcare data analysis and reporting within a clinical setting or healthcare environment.
• Proficiency in data analysis tools and software (e.g., SQL, Tableau, Excel).
• Strong understanding of healthcare operations, clinical workflows, and healthcare data systems.
• Excellent communication and presentation skills, with the ability to translate complex data into actionable insights.
• Meticulous, with strong problem-solving and critical-thinking abilities.

Work-at-home requirements

• Ability to provide a non-cellular high-speed internet service such as fiber, DSL, or cable modems for a home office.
• Minimum standard speed of 30x5 (30 Mbps download x 5 Mbps upload) is required.
• Latency (ping) response time lower than 80 ms.
• Hotspots, satellite, and wireless internet service are not allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.

Benefits

• Competitive pay/salary ranges with a target hiring range of $71,340 - $90,250 USD (current maximum salary for this role is $100,564 USD).
• Incentive plan.
• Health, vision, and dental benefits effective day one.
• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution.
• Robust employee well-being program.
• Paid Time Off.
• Personal Community Enrichment Time.
• Company-provided Basic Life and AD&D.
• Company-provided Short-Term & Long-Term Disability.
• Tuition Assistance Program.

While this is a remote opportunity, GEHA does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.