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Data Analyst (Medical Economics)

The Data Analyst (Medical Economics) is responsible for managing complex data analysis projects and leading analytical initiatives to support business operations across healthcare domains. This role involves advanced data modeling, reporting, and interpretation to drive data-based decision-making and compliance.

Time Zone Support: CST/EST. Candidates in PST must work 6:00 AM–3:00 PM PST (8:00 AM–5:00 PM CST or 9:00 AM–6:00 PM EST).

Key Responsibilities:

• Manage analytic data needs for assigned business units and projects.
• Lead complex data analysis efforts and mentor other Data Analysts.
• Extract, load, model, and reconcile large datasets from multiple systems and sources.
• Analyze claims, provider, member, clinical, HEDIS, pharmacy, and other healthcare data.
• Review data to identify operational issues, trends, improvement opportunities, and recommend corrective actions.
• Develop and present analytical reports, dashboards, and insights for management decision-making.
• Perform data modeling using MS Excel, SQL, Access, and data warehouse tools.
• Conduct advanced data quality audits and analyses to ensure regulatory compliance.
• Support performance reporting and deliverables required by federal and state requirements.
• Design efficient SQL queries, create tables and indexes, and optimize stored procedures.
• Utilize programming languages (Python or R) for statistical and analytical modeling.
• Perform financial modeling, ROI analysis, claims pricing, and contract/network analysis.
• Support emerging trend analysis and predictive analytics for strategic planning.
• Collaborate with cross-functional teams to ensure consistent, accurate data usage.
• Train and guide junior analysts and assist in workload planning.
• Perform other duties as assigned, maintaining compliance with internal policies and standards.

Required Qualifications:

• Bachelor's degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance, or a related field.
• Minimum of 5 years of experience with large databases, data verification, and data management, or at least 3 years of IT experience with a data focus.
• Strong SQL and query optimization skills (stored procedures, table creation, indexing).
• Proficiency with analytical tools such as MS Excel, Access, and data warehousing systems.
• Experience in healthcare analytics or related healthcare data domains (claims, clinical, provider, or pharmacy).

Preferred Qualifications:

• Master's degree in a relevant field.
• Experience using Python or R for data analysis.
• Knowledge of data mining, trend analysis, and root-cause analysis techniques.
• Familiarity with business intelligence and visualization tools (e.g., Tableau, Power BI).
• Experience in financial modeling, contract/network analysis, and healthcare risk adjustment.
• Understanding of claims payment processes and healthcare compliance standards.

Behavioral Competencies:

• Analytical and detail-oriented with strong problem-solving skills.
• Excellent verbal and written communication abilities.
• Ability to work independently and manage multiple priorities simultaneously.
• Collaborative mindset with a focus on continuous improvement.