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Role Description

Data Analyst for our Pre/PostPay Edit editing program. This position will provide the technical component of our Pre/PostPay Edit editing program in development, implementation, production monitoring and maintenance of our internal PrePay edits.

• Act as technical analyst for Proactive Claim Intervention projects and daily tasks for all aspects of our Pre/PostPay Edit editing program.
• Data Analyst for the development, installation, execution and maintenance of our Pre/PostPay Edit editing program.
• Develop and maintain editing on regular and ad-hoc basis, primarily using SAS, Microsoft SQL Server and internally developed ARM rule-based claim editing platform.
• Responsible for data mining activities and technology integration of Pre/PostPay Correction Program to support our Pre/PostPay Edit editing program.
• Evaluates and appropriately utilizes various approaches to data mining to narrow in on trends and drivers that directly impact outcomes.
• Makes well-thought-out decisions on complex or ambiguous IT architecture issues.
• Participate in all phases of Pre/PostPay Edit program IT architecture process testing and implementation.
• Ensures that system improvements are successfully implemented and monitored to increase efficiency.
• Works closely with matrix business partners to define data needs, opportunities for improvement and effectively communicates results of analysis and solutions.
• Acts as a resource for mentorship, training and guidance for junior staff.

Qualifications

• Bachelor’s degree or higher strongly preferred in Business Analytics, Data Science, Information Systems, or a related field, or equivalent work experience required.
• 5+ years of experience in healthcare data analytics required.
• 5+ years coding experience required, with proficient skills using SAS and Microsoft SQL Server highly preferred.
• Experience with rule-based editing platforms desired.
• 5+ years of experience in healthcare data with proficient skills in medical analysis and project management.
• Strong data investigation skills to mine healthcare data required.
• Experience with Word, Outlook, PowerPoint, Teams, Webex, Excel (pivot tables/VLOOKUP preferred).
• Strong data analysis skills with the ability to analyze large amounts of healthcare data to translate complex data into meaningful, actionable insights.
• Strong project management skills and comfort in ability to create and achieve success in highly matrixed environment.
• Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization to a drive toward resolution for the client, provider and organization.
• Strong presentation skills. Able to prepare, deliver, and ensure understanding of information regarding any customer-related or process improvement topic across audiences.
• Demonstrated ability to work independently and drive to objectives.

Requirements

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

• Comprehensive range of benefits, with a focus on supporting your whole health.
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k), company paid life insurance, tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.