General Purpose
We’re looking for a sharp and detail-oriented Data Analyst to join our growing team. The ideal candidate is a data detective with proven experience of uncovering hidden data insights and patterns and communicating them to stakeholders with compelling storytelling. This role plays a key part in identifying cost-saving opportunities and improving claim accuracy across group health and worker’s compensation plans. Data Analyst brings hands-on experience with healthcare claims data, strong technical skills (SQL, Python, PowerBI), and a passion for improving healthcare. This role will report to the Senior Director of Data Science.
Duties & Responsibilities
- Analyze group health and worker’s compensation claims data to identify cost-savings opportunities for potential and existing clients, billing practices, errors, and overpayments.
- Work closely with clinical and operational teams to interpret patterns in data and recommend process improvements.
- Develop analytical solutions with stakeholders to detect fraud, waste, and abuse (FWA).
- Build and maintain reports and dashboards that monitor claim activity and performance metrics.
- Translate business requirements into technical specifications for analytical projects.
- Communicate findings and recommendations clearly to both technical and non-technical stakeholders.
Qualifications
- Bachelor’s or Masters (preferred) degree in a quantitative field (e.g., Data Science, Mathematics, Statistics, Public Health).
- 3+ years of experience analyzing group health claims or related healthcare data.
- Proficiency in SQL, Python or R, Tableau or PowerBI for data analysis and visualizations.
- Experience working with SQL databases and Cloud Computing (AWS, Databricks, etc).
- Strong understanding of healthcare reimbursement methodologies and claims adjudication.
- Experience working in payment integrity, healthcare cost containment, or audit functions.
Preferred:
- Experience with medical coding standards (e.g., ICD, CPT, HCPCS).
- Familiarity with Medicare Advantage, Group Health and Worker’s Compensation payer systems.
- Prior experience in a managed care, payer, or third-party administrator (TPA) environment.
Classification: Salary Exempt
Status: Full-time Regular
Starting Salary: $75,000+
