Healthcare Data Analyst - Remote

About the job Healthcare Data Analyst - Remote

The Healthcare Data Analyst is responsible for analytics, financial analysis and claims auditing. This candidate will reside within the Analytics and Reporting department and will work closely with other members of the Clinical, Medical and Network teams to design and analyze operational and claims data. This person will also present results to internal stakeholders, existing and future clients. Additionally, the ideal candidate will serve as a leader in defining and prioritizing the strategic and tactical tasks surrounding future data intelligence.

Essential Functions

• Analyze business intelligence data to inform business and product decisions, blending historical results, available industry reports, purchased sources and public information as input to analyses
• Identify areas for increased clinical focus and review / assess associated action plans
• Maintain provider rate information and assess overall cost impact of proposed changes
• Support claims audit processes and procedures to ensure the fidelity of claims processing
• Conduct on-going refinement of the risk stratification surrounding claims processing
• Design, develop, interpret and present key internal business operational metrics reporting, serving as an ongoing voice for improving and increasing data intelligence leading to operational improvements
• Contribute to the identification and prioritization of improved reporting processes and procedures
• Provide on-going analysis and recommendations for improvement of operations and clinical interventions
• Provide direction in preparing and / or reviewing reports for publication.
• Assist with planning tactical goals to achieve major improvements in data analytics capabilities over time
• Adheres to our Mission Statement, Core Values, Code of Business Conduct and Compliance Program
• Complies with all Federal and applicable State laws and policies regarding privacy, confidentiality and security of health information and other designated information

EDUCATION & EXPERIENCE Required