• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data • Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy • Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions • Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients • Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections • Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability • Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs • Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements • Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities