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Healthcare Analytics Lead

2 months ago

Providence, Rhode Island, United States InterEx Group Full time

Position: Healthcare Analytics Lead

A prominent health insurance organization is seeking a Healthcare Analytics Lead to oversee a full-time role. This position is essential for guiding and interpreting healthcare quality metrics related to HEDIS scores and star ratings while managing the daily functions of the health data analytics division.

Key Responsibilities:

  • Provide leadership and technical guidance to team members, including goal setting, performance evaluation, and conducting reviews.
  • Analyze and present findings derived from healthcare claims, pharmacy, and laboratory data.
  • Supervise the development of analytical reports aimed at maintaining current market share and attracting new business through effective cost management strategies.
  • Establish and oversee procedures and protocols for health data research and analysis.
  • Evaluate operational processes to recommend enhancements for efficiency.
  • Collaborate with management to resolve issues identified during operational reviews.
  • Represent the analytics department in various committees and internal meetings, and act as the organization’s representative at external engagements.
  • Perform additional responsibilities as assigned.

Qualifications for Success:

  • Bachelor's degree in Computer Science, Mathematics, Economics, or a related discipline; or equivalent education and experience.
  • A minimum of five years of experience in health data analysis, business analysis, software applications, database design, and technical documentation, preferably within the health insurance sector.
  • Three to five years of experience in a management or team leadership role.
  • Proficient in health data analysis, business analysis, dashboard design, and database design, ideally within healthcare insurance.
  • Familiarity with healthcare quality metrics, including HEDIS scores and STARS ratings.
  • At least three years of experience with SAS, SQL, or Alteryx programming.
  • Experience with Power BI, Tableau, or similar dashboard and reporting tools for a minimum of three years.
  • Proficient in managing large-scale SQL Server or similar structured database platforms for at least three years.
  • Understanding of industry standards for developing analytics and reporting platforms.
  • Knowledge of claims processing and membership processing, including CPT-4 and ICD-9 coding.
  • Strong mathematical skills.
  • Demonstrated ability to coach, motivate, and enhance team performance.
  • Excellent communication skills for effectively conveying objectives and goals.
  • Strong decision-making, organizational, and time management abilities.
  • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, etc.).
  • Ability to interact effectively across all organizational levels.
  • Competency in delegating tasks and managing project responsibilities.
  • Strong verbal and written communication skills for articulating complex or technical information.
  • Ability to translate business strategies into actionable objectives and measurable outcomes.
  • Strong negotiation, influence, and consensus-building skills.

Preferred Qualifications:

  • Knowledge of applied statistics and econometric modeling.
  • HIAA certification.