Overview:

The Senior Healthcare Data Analyst I 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 Healthcare Data Analyst

participates in identifying progress, performance and opportunities for improvement on

programs, quality of care, patient experience, and other metrics. This position requires a

thorough understanding of healthcare data and workflows, combined with an extensive

experience working with large data sets, conducting data analysis, including standard statistical

software (SAS), and creating reports using Tableau.

Responsibilities:

Works collaboratively with business partners, other analysts, and IT to gather and

integrate data from disparate sources.

Responds to ad hoc data requests from business units and leadership

Assists in design and development of data collection strategies, aggregation, analysis,

and reporting to ensure data integrity and enhance information value.

Participates in design and interpretation of data analyses; provides recommendations for

improvement of data quality and reporting.

Helps build, manage, and/or enhance predictive models

Assesses reporting and automation requirements and develops appropriate solutions.

Maintains in-depth knowledge of health plan operations, including claims processing,

utilization management, quality improvement activities and pay for performance programs.

Critically analyzes data, draws conclusions and effectively articulates results.

Presents data and conclusions to non-technical audience; uses data visualizations and

summaries to highlight key findings.

Creates and maintains thorough and consistent documentation of programs used to

create reports.

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 the organization’s

analytic needs.

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.

General Traits

Passionate about data, willing to acquire new skills and knowledge, flexible, selfmotivated, and very curious.

Creative problem-solver, critical thinker, independent worker, data-driven mentality.

Communicates clearly and directly, relates well to others, engages people, provides and seeks feedback, articulates clearly, actively listens.

Qualifications:

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. 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, SAS and/or SQL a plus. Experience working with administrative data, ideally health care data (Medicaid data a plus). Understanding of health data formats including claims, lab and pharmacy. Knowledge of clinical coding systems (e.g., ICD9, ICD10, CPT).

Special Skills, Licenses and Certifications

Proficiency in inferential and predictive statistical analysis. MS Office, Excel, SQL, SAS, Tableau.

Ability to present complex information in an understandable and compelling manner.

Performance Based Competencies

Ability to quickly acquire in-depth knowledge of various systems related to claims processing, membership, provider, and benefits at PHC. Strong written and oral communication skills with ability to interpret and

understand technical requirements. Excellent analytical skills to troubleshoot and resolve data issues. 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.

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.

HIRING RANGE:

$(phone number removed) - $(phone number removed)

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.