Data Analyst - Remote

About the Role

Key Responsibilities

• Identify potential concepts for retrospective and prospective savings through individual ideation and from several perspectives such as correct network contracting, policy reimbursement, medical documentation requirements, industry and federal guidelines
• Identify root causes to shift the retrospective saving to prepay and further stages in the claim life cycle in the form of avoidance, automated prevention and manual prevention solutions
• Work collaboratively with business partners, SMEs, and BAs to ensure a shared understanding of business requirements
• Pull data of overpayment/claim paid data, sizing of Shift Left opportunity, socialization of ideas with different payment integrity solutioning teams and building relationships to deliver the result
• Examine, assess, and document business operations and procedures to ensure operational efficiency and excellence
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Use pertinent data and facts to ideate, identify and solve a range of problems within area of expertise
• Develop and maintain technical and user documentation
• Create output from Excel to Power BI from data analysis for client approval
• Comply with design and coding standards, policies, and procedures from management concept to deployment
• Communicate the outcome of research in a manner suitable for the intended audience
• Assist management with post-deployment reporting
• Work with less structured, more complex issues
• Leverage new technologies to drive innovation in healthcare data analytics
• Work independently and collaborate across diverse and matrixed teams

Requirements

• 5+ years of data analysis and/or audit experience within the healthcare industry
• 4+ years of experience using C&S claims adjudication platforms
• 3+ years of experience in managing cross-functional projects and making presentations
• 3+ years of experience pulling data using SQL or Python
• 2+ years of experience working with processing Post-pay or Prepay payment integrity
• Solid organizational and interpersonal skills
• Intermediate proficiency in MS Excel, Word, and PowerPoint
• Working knowledge of COSMOS, FACETS
• Agile trained (or willingness to complete agile training)
• Excellent oral and written communication skills
• Ability to learn internal technology tools and systems
• Ability to navigate a complex organization to accomplish customer satisfaction
• Solid analytical and conceptual thinking skills
• Ability to communicate effectively to both technical and non-technical individuals from diverse backgrounds

Nice to Have

• Beginner level of proficiency in MS Visio & Access

Qualifications

• Educational background is not explicitly specified but implied experience in healthcare data analysis and claims platforms

Benefits & Perks

• Competitive salary range of $71,600 to $140,600 annually
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Remote work flexibility