Data Analyst, Clinical Operations

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Completes the data analysis, reporting, and interpretation of all clinical operations reporting, supporting Care Management, Utilization Management, the Assessment Unit, and Pharmacy.
• Develops reports for clinical and non-clinical teams that increase visibility into operations, monitor staff productivity, measures clinical outcomes and utilization patterns, and facilitates process improvement.
• Acts as liaison to translate clinical/business needs to technical requirements.
• Leads exploratory analysis of complex clinical, financial, and operational data and apply statistical methods.
• Conducts ad hoc analyses to help identify operational gaps; drafts presentations, reports, publications, etc. regarding results of analyses for clinical operations.
• Completes cross-database coordination, data cleaning, data extraction, and data manipulation to analyze data coming from multiple sources including member eligibility, inpatient and outpatient claims, authorizations, EHR documentation, clinical assessments, and related data sources.
• Designs and implements complex data transformations to enable report automation.
• Identifies and summarizes trends in member utilization and care gaps and present key findings to stakeholders with recommendations for areas of improvement.
• Monitors internal performance against regulatory benchmarks through analysis.
• Performs root cause analysis to identify gaps in current workflows; meets with department leadership to solicit cooperation, establish priorities, and resolve problems. Provides business owners with analytical support for resolution of data management and business problems.
• Produces data cubes and creates analytics dashboards in MicroStrategy to monitor clinical operations performance.
• Develops a strong understanding of how clinical operational workflows, care management workflows, and business process changes map to data stored within database systems and ensures that this knowledge is disseminated to team members and other data consumers.
• Serves as liaison amongst clinical and administrative staff and IT to create and modify EHR documentation protocols that allow for clean and informative data output while also mitigating the administrative work of front-line staff.
• Defines the business requirements for the business intelligence and analytics teams to build dashboards for oversight and monitoring.
• Coordinates and performs data quality exploration and validation on new data sources.
• Develops data quality specifications and designs. Coordinates and supports integrated data systems for analyzing validating information.
• Analyzes and corrects error reports to ensure timely and accurate data; develops corrective actions to prevent errors where possible.
• Prepares detail and summary level reports including written interpretation of analytic results.
• Participates in special projects and performs other duties as assigned.

Education:

• Bachelor's Degree in Bio/Statistics, Mathematics, Public Health, Epidemiology, Healthcare Informatics or related field with equivalent knowledge required
• Master's Degree in Bio/Statistics, Mathematics, Public Health, Epidemiology, Healthcare Informatics or related field with equivalent knowledge

Work Experience:

• Minimum of two years' experience performing data analysis and interpretation, preferably in a managed care or health care setting required
• Experience with data extraction and manipulation required
• Proficiency in SQL, SAS, Excel required, Access experience preferred
• Experience with claims data and health plan quality metrics (e.g., HEDIS, QARR) preferred
• Proficiency conducting statistical analysis with R, SAS, or Python preferred
• Proficiency creating data visualizations and dashboards using MicroStrategy, Tableau, PowerBI or other visualization software preferred
• Advanced personal computer skills, including Microsoft Word, PowerPoint, Excel, and Access required
• Effective oral, written communication and interpersonal skills required
• Ability to multi task in a fast-paced environment required