The Senior Health Data Analyst contributes to the overall success of the organization by developing analytic solutions that support activities related to health services utilization management, care coordination, quality improvement and population health. Through analyzing patient claims, member enrollment, and other data, the Senior Health Data Analyst participates in identifying progress, performance and opportunities for improvement on programs, quality of care, patient experience, and other metrics. The Senior Health Data Analyst requires a thorough understanding of healthcare data and workflows, combined with an extensive experience creating large data sets, conducting statistical data analysis (SAS), and using BI tools (Tableau).
- Works closely with other members of the Health Analytics team, as well as the Financial Analytics and Data Warehouse teams to gather key data from various internal and external systems.
- Creates data sets, extracts and synthesizes data; conducts and interprets quantitative analyses.
- Prepares a variety of reports, including statistical analyses and dashboards that allow key stakeholders to make informed business decisions based on data.
- Assists in design and development of data collection strategies, aggregation, analysis, and reporting to ensure data integrity and enhance information value.
- Generates a quality work product, presentable for content and audience, in a timely manner while maintaining strong attention to detail.
- Manages and prioritizes workload while meeting deliverables and expectations.
- Works autonomously and collaboratively with report requestors, providing guidance to define report requirements and validate results.
- Works collaboratively across departments to understand and meet analytic needs.
- Researches and recommends areas for improvement of data quality and reporting.
- Maintains in-depth knowledge of health plan operations, including claims processing, utilization management, quality improvement activities and pay for performance programs
- Documents report processes/logic and actively engages in department’s documentation efforts to improve knowledge base of team.
SECONDARY DUTIES AND RESPONSIBILITIES
- Performs other assigned or needed activities required to assure success of the organization.
- Participates in special projects as needed.
- Performs other duties as assigned.
Education and Experience
Bachelor’s degree with concentration in health informatics, health administration, public health, computing, epidemiology, statistics or related field, Master’s degree preferred. Minimum four (4) years of experience in data analysis and reporting.
Special Skills, Licenses and Certifications
Knowledge of major health plan operations: healthcare claims processing, membership, provider, and benefits; or equivalent combination of education and experience. Excellent knowledge of data collection, analysis, statistics and data presentation with experience in data mining techniques and procedures. Experience using statistical packages for analyzing large data sets. Experience working with administrative data, ideally health care data. Understanding of health data formats including claims, lab and pharmacy. Knowledge of clinical coding systems (e.g., ICD9, ICD10, CPT). Proficiency in inferential and predictive statistical analysis. Proficiency in business software applications such as Microsoft Office Suite, SQL, SAS, and Tableau.
Performance Based Competencies
Must demonstrate strong verbal and written communication skills. Ability to clearly communicate complex information to diverse audiences. Ability to communicate data needs to various customers (internal and external) in order to compile and produce necessary reports. Excellent analytical, problem solving, investigative and research ability. Ability to work in a team environment, take and give direction, follow through with tasks and projects, compromise, negotiate and achieve consensus decisions, support consensus decisions, be flexible and adaptable to changes in assignments and the work environment, work independently, manage time efficiently and multi-task effectively. Ability to make decisions that require significant analysis and investigation with solutions requiring critical thinking. Ability to quickly acquire in-depth knowledge of various systems related to claims processing, membership, provider, and benefits at PHC. Ability to present complex information in an understandable and compelling manner. Ability to interpret and understand technical requirements. Must be highly organized and proficient at multi-tasking. Must be willing and able to provide gracious assistance to users, providers, and other constituents of PHC.
Work Environment And Physical Demands
More than 50% of work time is spent at a video display terminal. May be required to bend, stoop, kneel, crawl, or work in other non-standing and non-sitting positions to install cabling, systems hardware, and other related equipment.
All HealthPlan employees are expected to:
- Provide the highest possible level of service to clients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.