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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 and interpret healthcare quality metrics related to HEDIS scores and star ratings. This role is essential for managing the daily functions of the health data analytics division.

Key Responsibilities:

  • Guide and provide technical oversight to team members, including establishing objectives, assessing performance, and conducting evaluations.
  • Analyze and present findings derived from healthcare claims, pharmacy, and laboratory data.
  • Supervise the development of analytical reports aimed at maintaining market share and attracting new clientele through effective cost management strategies.
  • Formulate and oversee procedures for health data research and analysis.
  • Examine and assess operational workflows to propose enhancements for efficiency.
  • Collaborate with leadership to resolve issues identified during operational reviews.
  • Represent the analytics department in various committees and internal discussions, and act as the organization’s representative in external engagements.
  • Perform additional responsibilities as required.

Qualifications:

  • Bachelor's degree in Computer Science, Mathematics, Economics, or a related discipline; or equivalent experience.
  • A minimum of five years in health data analysis, business analysis, software applications, database design, and technical documentation, preferably in the health insurance sector.
  • Three to five years of experience in a managerial or leadership capacity.
  • Proficiency in health data analysis, business analysis, dashboard design, and database architecture, ideally within the healthcare insurance domain.
  • Familiarity with healthcare quality metrics such as HEDIS scores and STARS ratings.
  • At least three years of experience with SAS, SQL, or Alteryx programming languages.
  • Experience with Power BI, Tableau, or similar data visualization and reporting tools for a minimum of three years.
  • At least three years of experience with large-scale SQL Server or comparable structured database systems.
  • Understanding of industry standards for developing analytics and reporting frameworks.
  • Knowledge of claims processing and membership management, including CPT-4 and ICD-9 coding.
  • Strong mathematical skills.
  • Demonstrated ability to mentor, inspire, and enhance team performance.
  • Excellent communication skills for effectively articulating goals and objectives.
  • Strong decision-making, organizational, and time management capabilities.
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, etc.).
  • Ability to engage effectively with all levels of the organization.
  • Competence in delegating tasks and managing project responsibilities.
  • Strong verbal and written communication skills for conveying complex 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.