- Create end-to-end data solutions; including building data set to visualization tools, for clinical operations data delivery and analytic solutions. Extract, manipulate, cleanse and validate data from various sources used for analysis.
- Perform complex data analysis and studies to evaluate populations, programs, clinical outcomes, and trends to support STARS and Population Health initiatives.
- Collaborate with other IT and analysts across the health plan on modeling and advanced data techniques.
- Develop business requirements for projects and new solutions and/or reports. Understand business operations, clinical and financial concepts, and customer requirements to determine best approach to providing information to solve business questions and problems.
- Regularly review existing systems and make recommendations for improvements. Support, maintain, and troubleshoot clinical operations data delivery solutions with the ability to perform root cause analysis (RCA).
- Support clinical analytics leadership as another resource to cover other team members workflows while team members are on leave.
- Ensure compliance with state and regulatory rules with regards to PHI.
- 8 years as a data analyst, research analyst or similar type of role.
- 5 years' experience SQL programming with data management and data analysis tools; understanding of Relational Databases and Business Process Alignment.
- 5 years' experience using statistical tools for analyzing large datasets.
- Knowledge of Economics and Accounting principles and practices, and reporting of financial data, CPT, ICD-10, and HCPCS coding system.
- Knowledge of Medicare/Medicaid/Medigap coverage/guidelines and Commercial.
- Expert level of proficiency with Power BI, MS Excel, and other Microsoft tools creating reports and other data visualizations.
- Possess excellent analytical and problem solving skills.
- Desire to learn to use new technology, applications, and methodologies.
- Strong soft skills, verbal and written communication, including the ability to translate complex technical topics into understandable terminology, is a necessity.
- Proven ability to lead specific functions of large projects and initiatives.
- Ability to build trust among colleagues.
- Majority of time involves sitting or standing; occasional walking, bending, stooping.
- Long periods of computer time or at workstation.
- Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
- May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise
- Communicating with others to exchange information.
- Visual acuity and hand-eye coordination to perform tasks
- Workspace may vary from open to confined; on site or remote
- May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle
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Health Clinical Data Analyst Sr - Rockledge, United States - Health First
Description
Position SUMMARYThe Clinical Data Analyst Senior serves as a member of the clinical analytics team. They will work to satisfy key business initiatives by delivering data and analytics solutions and analyses.
The Clinical Data Analyst Senior will build clinical data models, data sets and automated reporting as well as handle day to day reporting needs.
They are a lead contributor to strategies, standards, new capabilities, and design to enable faster and easier data access, automated workflows, and development of data and analytics services within clinical operations.
The Clinical Data Analyst Senior proactively works with customers, stakeholders, analysts, architects, and other system data resources to troubleshoot and find root cause of solution defects.
Primary AccountabilitiesMINIMUM QUALIFICATIONS
Education:
Bachelor's Degree in Economics, Statistics, Analytics, Mathematics or Healthcare Administration or related field.
Licensure:
None required.
Certification:
Complete Pragmatic Works Advanced Power BI and Advanced SQL within one year of hire.
Work Experience:
PREFERRED QUALIFICATIONS
Education:
Master's Degree in Analytical related field.
Licensure:
No additional.
Certification:
No additional.
Work Experience:
6 years of experience within Healthcare, 3 years of experience with Health plan; Healthcare or health insurance data analysis experience.
Knowledge/Skills/Abilities:
HMO/Health Insurance contracts.
PHYSICAL REQUIREMENTS
