Senior Data Analyst, Clinical Programs

Primary Responsibilities

• Monitor Utilization Management and Case Management activities through the development of KPIs and benchmarks (i.e. member engagement rates, readmissions, preventable hospitalizations, ER utilization)
• Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources.
• Develop algorithms for stratifying populations and identifying high-risk members.
• Leverage Predictive Analytics to measure the performance (ROI) of Disease Management and other Medical Management programs.
• Conduct prospective savings analyses in support of clinical program initiatives.
• Build and maintain client-facing reports, dashboards, and analyses.
• Develop actionable data insights and advise on client strategy
• Participate in program performance review presentations with clinical program managers, client account managers, and external clients, as needed.
• Manage internal and external client requests and timelines to ensure timely delivery.
• Collaborate with Medical Management to provide ongoing support.

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.