Affinity is seeking an experienced Healthcare Data Analyst. The Healthcare Data Analyst will be responsible for providing reporting, analytical, project management and administrative support to the medical management team to ensure that quality improvement and key improvement activities within AMS are met timely and successfully. The position requires an understanding of health care data (eg. Member, claims, clinical, and provider data) coupled with knowledge of data analysis methodology and analytical tools for reporting.
Our Medical Management team aims to enhance the health status and care experience of our member population, and do so at a lower cost. Our approach to improvement includes partnering with the health plans, providers, and vendors to improve care through coaching and training. As a key member of the team, the ideal candidate must have people skills as well as an organized, detailed approach to data analysis, presentation, and project management.
Specific Duties and Responsibilities
- Gather, read, analyze, and interpret complex data and create meaningful information for data reporting and decision support to evaluate the clinical and economic effectiveness of clinical programs, return-on-investment analyses.
- Project management support for the HCC, California P4P, and Medicare Star programs, crucial projects focused on clinical care excellence.
- Proactive representation of the department’s needs and priorities with organizational leaders and executive management.
- Coordination and support for quality program data pursuit, i.e. automate data transfer surrounding pay for performance/clinical quality programs and perform QA on possible data gaps.
- Build statistical models to forecast /predict future healthcare utilization and comparative analysis of current utilization.
- Interpret results of clinical programs and build dashboards and reports for providers and leaders within the organization.
- Develop and automate SQL and SAS Codes to extract and manipulate data, implement evaluation design and conduct statistical analysis.
- Work with vendors to ensure accuracy of data streams.
- Complete special projects and other duties as assigned.
- Bachelor’s degree in Computer Science, which may be substituted with equivalent work experience
- Prior experience at a healthcare organization, particularly at a managed health plan
- Proven ability to extract and synthesize data, conduct and interpret quantitative and qualitative analyses.
- Experience with complex logic and requirements.
- Experience with validating and auditing data.
- Database-related development skills (SQL queries in SQL Server 2008); proficient knowledge levels in Access and Excel or equivalent database and reporting.
- Able to facilitate meetings, make presentations before groups of management and staff.
- Ability to work effectively in a multidisciplinary team/multidisciplinary departmental approach to customer service.
- Resourceful and inquisitive.
- Ability to plan and execute projects independently.
- Strong experience with Microsoft SSRS.
- Strong database-related development skills (complex SQL queries, complex stored procedures and user-defined functions in SQL Server 2005 and 2008).
- In depth knowledge with data analysis, data modeling and data mart design skills.
- Ability to synthesize data from various sources and perform various types of data analysis.
- Experience with standard regulatory reporting requirements such as HEDIS measures.
- In-depth knowledge of industry standard health data code sets such as ICD-9/ICD-10, CPT/HCPCS, revenue codes, and NDC (Pharmacy).
- Strong organization, time management and multi-tasking abilities.
- Solid analytical skills and problem solving skills with the ability to formulate and communicate recommendations for improvement.
- Have the ability to work effectively with others and have good interpersonal skills.
- Be highly organized and work well under pressure.
- Must be willing to accept responsibility and to show good judgment, initiative, and resourcefulness.
Indeed - 19 months ago