Senior Specialist

JOB SUMMARY

This position leads the design, development, analysis, and delivery of complex analytics solutions that support operational, client, network, and business decision-making. The incumbent integrates healthcare data, analytical methods, reporting technologies, and business expertise to generate actionable insights, improve solution performance, automate processes, and provide technical and strategic guidance to stakeholders.

JOB ROLES AND RESPONSIBILITIES

Lead complex analytical initiatives that integrate healthcare claims, provider, financial, operational, client, and market data to identify trends, root causes, risks, opportunities, and expected business outcomes. Design, develop, test, maintain, and enhance scalable analytics solutions, including reports, dashboards, data extracts, queries, applications, models, and automated workflows that meet defined business and technical requirements. Partner with internal and external stakeholders to define analytical needs, translate business questions into solution requirements, evaluate source data, identify gaps, and deliver accurate and actionable results. Interpret complex analyses and communicate findings, recommendations, and solution performance through clear reports, visualizations, presentations, and client-ready materials for technical and non-technical audiences. Apply advanced SQL, business intelligence, data visualization, programming, and database tools to manage large data sets, optimize queries and processes, troubleshoot defects, and improve solution quality and performance. Drive continuous improvement efforts by evaluating business processes, analytical methodologies, reporting workflows, and data practices; identify opportunities for automation, standardization, efficiency, quality enhancement, and implement solutions that deliver measurable business value. Coordinate complex cross-functional projects and solution enhancements; develop work plans, monitor status and risks, resolve issues, document decisions, and support testing, release, implementation, and production activities. Serve as a senior subject matter resource and strategic advisor on healthcare analytics, data, reporting, and solution design; mentor less experienced team members and provide technical or project guidance as needed. Collaborate, coordinate, and communicate across disciplines and departments. Ensure compliance with HIPAA regulations and requirements. Demonstrate Company's Core Competencies and values held within. Please note due to the exposure of PHI sensitive data, this role is considered to be a High-Risk Role. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE

The incumbent works under limited supervision as a senior individual contributor and exercises substantial discretion and independent judgment in planning and delivering complex analytics solutions. Work is varied and requires advanced analytical, technical, healthcare, and business knowledge to address non-standard issues, evaluate alternatives, and recommend actions with operational, client, financial, or strategic impact. The role has regular contact with leaders, clients, technical teams, and business partners and may lead projects or collaborations with less experienced team members. This position does not directly manage others. JOB REQUIREMENTS (Education, Experience, and Training) Minimum bachelor's degree in data science, statistics, mathematics, computer science, information technology, economics, finance, business, public health, healthcare informatics, or a related field, or High School Diploma/GED and four years of related experience. Minimum 5 years of experience in healthcare analytics, business intelligence, reporting, data solutions, software or report development, healthcare economics, or a related analytical field. Experience leading complex analytical projects and managing large data sets, business requirements, reporting processes, or solution-development activities. Required licensures, professional certifications, and/or Board certifications as applicable. Advanced knowledge of SQL, relational databases, data structures, data extraction, data transformation, data quality, query optimization, and reporting or visualization practices. Experience with business intelligence and visualization tools, such as Power BI, Tableau, SSRS, or comparable platforms, and advanced Microsoft Excel capabilities. Experience with programming or analytics tools, such as Python, R, C#, .NET, ETL tools, or comparable technologies, preferred based on assignment. Knowledge of healthcare claims, billing, reimbursement, provider, network, benefits, population health, payment integrity, or healthcare operations concepts preferred. Advanced analytical, problem-solving, troubleshooting, decision-making, research, organization, project-management, and attention-to-detail skills. Strong verbal, written, presentation, data-visualization, and consultative communication skills, including the ability to translate complex technical findings into actionable business insights. Ability to independently manage multiple complex priorities, meet deadlines, assess business impact, and adapt to evolving technology and customer requirements. Ability to build collaborative relationships, influence without direct authority, lead cross-functional work, and mentor less experienced team members. Ability to use generative artificial intelligence and automation tools responsibly to support data exploration, documentation, query development, reporting, or process efficiency, as appropriate. Ability to travel occasionally as needed. Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities. Your benefits will include: Medical, dental and vision coverage with low deductible & copay Life insurance Short and long-term disability Paid Parental Leave 401(k) + match Employee Stock Purchase Plan Generous Paid Time Off - accrued based on years of service WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service 10 paid company holidays Tuition reimbursement Flexible Spending Account Employee Assistance Program Summer Hours Sick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.

COMPENSATION

The salary range for this position is $75,748K- $125K. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

EEO STATEMENT

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted. #J-18808-Ljbffr MultiPlan