The Senior Healthcare Data Analyst manages, standardizes, develops, implements, performs and supports data exchanges within the organization and external organizations and the data management process within the department. This position will be the senior consultant to other analysts by providing guidance as to best practices and methodologies. Special projects that require exceptional analytical skills and a keen understanding of issues and practices used in the health insurance industry will be assigned to this position.
- Manages data exchanges within the company and other external organizations.
- Standardizes and automates data management processes within Informatics.
- Develops and implements standardized process to provide ongoing patient information to operations to support their special care management programs.
- Implements routine ongoing reports and improve reporting processes.
- Mentors other analysts in defining methodologies and coding to improve efficiencies and accuracy.
- Supports operational/strategic analysis by developing and maintaining models that will have an impact on executive management decision making.
- Performs routine data analysis include cost and utilization trends, cost driver analysis, etc.
- Supports other data management and reporting related projects as needed.
- Performs other duties as assigned within the scope of responsibilities and requirements of the job.
- Performs Essential Job Functions and Duties with or without reasonable accommodations
Education and Certifications
Knowledge and Experience
- Bachelors degree in Statistics, Economics, Mathematics, Informatics, Computer Science, or related field or equivalent work experience required
- Preferred: Master’s degree in Statistics, Economics, Mathematics, Informatics, Computer Science, or related field
- Advanced training in SAS and SQL
Essential Skills and Abilities
- 10+ years of direct experience minimum in Healthcare analytics and claims data analysis
- 10+ years of experience in SAS programming (SAS-Base, SAS-Stats, SAS-SQL)
- Deep knowledge and experience in managing claims data including medical claims, Rx claims and membership data files
- Strong knowledge of claims coding and claims processing.
- Knowledge of health care industry trends and practices.
- Strong knowledge of statistical tools and methodologies including risk adjustments.
- Clear understanding of healthcare data analytics, especially for cost and utilization trend analysis
- Advanced level Microsoft Office skills (PowerPoint, Word, Outlook)
- Advanced level Microsoft Excel skills
- Work independently on data management projects
- Identify claims data issues and get them resolved effectively
- Formulate, design, and create analyses for a wide array of Fund initiatives under consideration by executive management.
- Communicate data issues with internal and external customers
- Meet tight project timelines
- Develop and enhance ongoing processes to provide patient level information to operations