Sr. Healthcare Analyst

Job Description

The Sr. Healthcare Analyst provides information to leadership and utilizes subject matter expertise as well as exceptional analytic skills with a focus on a specific population or medical category to design and deliver analytic products that will help leadership make decisions to drive change. S/he leads junior analysts/other team members in setting definitions and efficient ways to analyze various healthcare concepts, assist in translating the analytical requirements into easy to follow data directions, is able to forecast and model future medical expenses, understands the impact of risk adjustment on financial results and assists in finding physicians’ performance related efficiencies by guiding others into desired area of opportunity. Handles the data with confidentiality especially around PHI and sensitive information.

Responsibilities

• Work with a variety of tools (ex: SQL, Excel, Access, Tableau, etc.) to access data, write queries, develop programming logic, organize data, manipulate, and analyze large datasets.
• Integrate other data sources into applicable analyses.
• Present analytical findings in a variety of formats (reports, PowerPoint, Tableau, graphs, figures, and tables), formulate recommendations, and effectively present results and recommendations to non-analytic audiences.
• Build and foster relationships with senior leadership/physicians and key stakeholders to understand multifaceted business problems and develop analytical solutions to complex issues to satisfy reporting and analytical needs.
• Perform own quality checks on performed analyses and utilize internal benchmarks to verify the results and perform quality checks on analyses performed by junior analysts/other team members.
• Incorporate CHIA cost relativity benchmarks into analyses when appropriate.
• Document performed processes and assure the correct documentation exists and is appended to the analyses.
• Collaborate with the Medical Director(s) and business associates (e.g., healthcare plan, PBM, consultants) to define the best approaches to find areas for improvement and trend mitigations.
• Serve as analytical resource and internal consultant for organization’s multidisciplinary quality and utilization improvement initiatives.
• Design analyses that calculate cost savings opportunities for BILHPN’s population(s) or specific population segments by utilizing future and retrospective risk scores and other financial adjustments.
• Provide clinical and administrative leaders with routine and timely updates on key clinical quality and utilization indicators at the network/population/service category level.
• Prepare reporting package for the Board of Directors and other Senior Executives.
• Collaborate with others to identify, understand and promote opportunities to analyze data more efficiently and accurately.
• Lead and guide the development of analyses to produce meaningful information.
• Assist the Dir, Performance Analytics and Reporting in training junior analysts/other team members, recommend appropriate training sessions or occasionally prepare and run the training.
• Take initiative and proactively suggest which areas of healthcare trends need to be analyzed at a deeper level and stay on top on industry specific development.

Requirements

• Master's degree in a quantitative field such as statistics, mathematics, economics, or public health, or equivalent practical experience.
• Minimum of 5 years of experience in healthcare analytics, data analysis, or related field.
• Experience with healthcare data sources including claims, financial, and clinical data.
• Strong proficiency in SQL, Excel, Tableau, and other data analysis tools.
• Excellent communication and presentation skills, with the ability to explain complex data-driven insights to non-analytic audiences.
• Ability to manage multiple projects simultaneously and prioritize tasks effectively.
• Strong problem-solving and critical thinking skills.
• Experience with healthcare cost and utilization management.
• Knowledge of risk adjustment methodologies and their impact on financial results.
• Experience with data visualization tools and techniques.
• Experience with healthcare data privacy and security regulations.

Qualifications

• Proven ability to work independently and collaboratively with cross-functional teams.
• Strong understanding of healthcare systems and operations.
• Experience with healthcare quality improvement initiatives.
• Ability to manage and analyze large datasets using statistical software.
• Experience with healthcare cost and utilization management.
• Knowledge of healthcare data privacy and security regulations.

Skills

• Data analysis and interpretation.
• SQL and other programming languages.
• Data visualization and reporting tools (Tableau, Power BI).
• Healthcare data sources (claims, financial, clinical).
• Healthcare cost and utilization management.
• Risk adjustment methodologies.
• Data privacy and security.

Benefits

• Flexible work schedule.
• Competitive benefits package.
• Professional development opportunities.
• Employee assistance program.
• Health and wellness programs.

Pay

$83,200.00 USD – $124,800.00 USD

Schedule

Full-time