Government Programs Claims Analyst - Metrics and Monitoring

Job Summary

At Delta Dental of Michigan, Ohio, and Indiana, we work to improve oral health through benefit plans, advocacy, and community support. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

Position Description

Analyses, monitors, and reports on claims processing using advanced data analytics and visualization techniques as well as identifies trends, risks, and improvement opportunities. Primary Job Responsibilities include:

• Develops, maintains, and enhances dashboards and reports using Power BI, Tableau, or similar data visualization tools to monitor claims performance and operational metrics.
• Analyzes claims data to identify trends, anomalies, root causes, and performance gaps related to timeliness, accuracy, cost, utilization, and compliance.
• Maintains accuracy and consistency across reports and dashboards.
• Automates recurring reports and improves reporting efficiency where possible.
• Contributes to continuous improvement initiatives related to claims processing and data analytics.
• Performs basic SQL queries and works with Government Programs Reporting for more complex queries.

Minimum Requirements

• Bachelor’s degree in health administration, business, data analytics, finance or related field.
• Three years of experience analyzing or resolving business, system or process issues within the healthcare or insurance industry.
• Previous experience in the administration of Medicare and/or Medicaid programs is preferred.

Preferred Qualifications

• Experience with data visualization tools, specifically Power BI and/or Tableau.
• Proficiency in SQL or similar querying tools.
• Strong analytical skills.
• Strong attention to detail and data accuracy.
• The ability to work independently and as part of a team.
• The ability to manage multiple assignments with competing deadlines.
• Effective verbal and written communication skills.
• The ability to resolve complex problems using independent judgement.

Company Commitment

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.