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Role Description

The Senior Data Analyst (Operations) supports and optimizes OncoHealth’s prior authorization data workflows by ensuring accurate, timely, and compliant data exchange across payer, vendor, and internal systems. This role combines deep knowledge of healthcare authorization processes with strong technical and analytical skills to manage X12 278 transactions, API integrations, and multi-source data reconciliation. The analyst partners closely with Engineering, Clinical Operations, Product, and Client Success teams to troubleshoot issues, improve turnaround times, reduce denials, and ensure data integrity across the prior authorization lifecycle.

• Manage, validate, and monitor prior authorization data flows in compliance with X12 278 standards.
• Support and maintain API-based and file-based authorization integrations.
• Develop dashboards and reports tracking authorization volumes, turnaround times, and outcomes.
• Support testing of new features and workflow changes impacting authorizations.
• Maintain detailed documentation of authorization workflows and integrations.
• Ensure workflows align with URAC standards and CMS guidelines.

Qualifications

• Bachelor’s degree or relevant experience required.
• 5-7 years of experience in data processing and analysis.
• Experience with RxClaim, JUDI, or similar authorization systems.
• Familiarity with prior authorization wrapper implementations.
• Background in healthcare operations or digital health analytics.
• Proficiency in SQL and experience with Python or similar tools.
• Strong analytical, problem-solving, and communication skills.
• Strong understanding of X12 EDI standards, especially 278 transactions.
• Hands-on experience with REST and/or SOAP APIs.
• Experience reconciling data across multiple healthcare systems.

Location

OncoHealth is committed to remote, hybrid or in office work options. The majority of the team will be remote or in hybrid work arrangements with offices in Atlanta, GA and Guaynabo, PR. We are open to employees nationwide but work primarily in the Eastern and Central Time Zones.

Culture

Taking ownership of quick action, critically thinking through the needs, and working well with others are key competencies of team member success. Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation – all with a focused mission of putting patients first!

• We offer a full benefit package on your first day, along with a company bonus.
• You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter.
• We enjoy being together!

Equal Opportunity Statement

OncoHealth is committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and team members without regard to race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. All employment decisions are based on qualifications, merit, and business need.

Opportunity

The cost of cancer related medical services and prescription drugs in the United States is expected to reach $246 billion by 2030. OncoHealth has enjoyed rapid growth over the past 3 years and seeks smart, collaborative people to join its team. We have just under 250 team members, so we can move swiftly but precisely to the market needs of our customers. Strongly backed financially by Arsenal Capital Partners & McKesson Corporation, we remain in an investment and growth mode. This means we are open-minded to how we get the work done – now is the perfect time to talk to us!

Current Solutions

• Through the use of OncoHealth's utilization management system, OneUM, our customers can use a single e-Prior Authorization portal for all oncology drug request and treatments. Our system improves quality of care, reduces provider abrasion and gives health plans visibility into the total cost of oncology treatment.
• OncoHealth offers Oncology Insights Pro, an analytic software solution that enables health plans to use data and analytics to improve oncology programs. Using real world data, our engineers normalize data to create analytic dashboards with drill down compatibilities. The data is paired with expert guidance providing the strategies and insight needed to keep up with the continuing evolving cancer treatment landscape.
• OncoHealth offers Pharmacy Consulting services to health plans and pharmaceutical companies. New cancer treatments are entering the market at an unrelenting pace. Since 2018, the FDA approved 121 new cancer applications including 49 novel cancer drug entities. Our Board-Certified Oncology Pharmacologists can help health plans update drug policies, offer utilization management and formulary advice, and development training for staff.
• OncoHealth's latest offering is Iris, a digital telehealth platform that delivers personalized, oncology-specific support to navigate the physical symptoms and emotional challenges caused by cancer and cancer treatment. Powered by technology, staffed 24X7, and delivered with empathy, Iris allows patients to connect with trained oncology experts and receive personalized, oncology-specific telehealth support.