The JobTh
e Healthcare Analyst III develops, documents, and programs in support of 5-Star projects and in-house initiatives. In pursuit of high 5-Star ratings, conducts in-depth data analysis and interpretation, HEDIS reporting, and other related tasks.
You Will- Responsible for research and moderate analysis of Medicare Advantage and healthcare data specific to membership, provider, claims, authorizations, pharmacy, and financial information.
- Designs and produces timely and meaningful analysis and data interpretation regarding large health care related datasets, related to 5-Star ratings, HEDIS, state specific programs (such as QIP/PIP), programs issued by state agencies (such as DHCS or HSAG) and other associated company initiatives.
- Leads in development, implementation, and document quality assurance (QA) processes to ensure that reported data is accurate and reliable.
- Conducts data management, quality improvement studies, statistical analysis, and report generation. Presents findings to higher level Analysts as well as HCI mid and senior management.
- Performs moderate to complex analysis and interprets organizational data, including but not limited to data mining, data verification, mapping, scrubbing, and scrapping.
- Develops and deliver actionable and supportable findings within tight deadlines and changing requirements.
- Conducts investigative research to uncover root causes, interpret results, identify trends, and make recommendations for action.
- Works directly with internal and external stakeholders to troubleshoot and correct data anomalies.
- Manages multiple moderate to complex projects concurrently. Completes them accurately within a specified timeline by effectively prioritizing work and communicating workload issues to manage-ment.
- Leads in training, providing guidance, and supporting lower level Analysts.
- Serve as a point of contact for internal and external customers and resolves both routine and more complex questions and problems. Escalates only the most complex issues to higher levels as needed.
- Ensures understanding of business needs by proactively monitoring and clarifying the technical responses to business requirements on all Medicare related projects.
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
- Actively support the achievement of SCAN's Vision and Goals.
- Other duties as assigned.
Your Qualifications- Bachelor's or above degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines required.
- 5+ years of analytical experience, or 4+ years of analytical experience in a Healthcare, Managed Care environment required.
- Experience with HEDIS is preferred.
- Experience with medical claims / encounters data is preferred.
- MS Office Suite at advanced level required.
- Proficiency with MS SQL (queries) required.
- Snowflake experience is preferred.
- SQL Server Reporting Services and SQL Server Integration Services experience preferred.
- SAS (Statistical Analysis System) experience preferred.
- Power BI tool experience preferred.
- Excellent technical, interpersonal written and oral communication skills required.
What's in it for you?- Base Pay Range: $92,400 to $133,671 annually
- Work mode: Mostly Remote
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- 11 paid holidays per year, 1 floating holiday, and 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
