Data Analyst I

This is a fully remote position, open to applicants in Texas.

📋 Description

• Convert pharmacy, healthcare, operational, and client data into reliable insights that enhance pharmacy benefit program performance, operational efficiency, cost management, and patient outcomes.

• Collect, validate, and analyze data from pharmacy claims, eligibility, formulary, clinical programs, prior authorization, customer operations, pharmacy networks, vendor files, APIs, and other PBM-related sources.

• Work with structured and semi-structured data across SQL Server, Snowflake, MongoDB or other NoSQL databases, cloud data platforms, flat files, and enterprise reporting environments.

• Collaborate with IT and data engineering teams to comprehend data pipelines, data models, source-to-target mappings, business rules, lineage, and data quality controls.

• Write, optimize, and validate SQL queries and analytical logic for recurring reporting, dashboards, ad hoc analysis, operational monitoring, and decision-making.

• Create and sustain dashboards, scorecards, self-service reports, and visualizations using Power BI, Tableau, Excel, or comparable platforms.

• Examine trends, patterns, outliers, and performance drivers across time periods, client segments, claim types, operational processes, and benefit plan designs.

• Convert business inquiries into analytical methodologies, establish KPIs, document metric logic, and deliver actionable insights.

• Utilize AI-enabled analytics tools, natural-language query capabilities, and automation for data profiling, variance analysis, documentation, forecasting, and insight generation.

• Implement statistical techniques, forecasting methods, and basic machine learning concepts for cost, utilization, operational, and clinical program analysis.

• Identify opportunities to automate recurring reporting, exception monitoring, data validation, and client-facing analytics while ensuring accuracy, explainability, and governance.

• Develop and implement data validation, reconciliation, and output verification processes.

• Support data governance by documenting definitions, assumptions, business rules, report logic, data sources, and change impacts.

• Safeguard confidential information and adhere to HIPAA, PHI handling requirements, privacy policies, security standards, and internal compliance procedures.

• Assist with audits, regulatory reporting, client inquiries, and issue investigations.

• Offer recommendations to enhance pharmacy benefit programs, formulary strategies, prior authorization processes, claim adjudication, client outcomes, and operational performance.

• Collaborate with pharmacists, account managers, operations leaders, product owners, compliance partners, vendors, and technology teams.

• Convey complex findings through narratives, dashboards, presentations, and recommendations tailored to leadership, client-facing teams, and operations.

• Report suspected HIPAA violations and complete necessary HIPAA training.

• Maintain flexibility as duties, responsibilities, technologies, and priorities evolve.

⛳️ Requirements

• Bachelor's degree in Data Analytics, Information Systems, Computer Science, Statistics, Business Analytics, Healthcare Informatics, or a related field; equivalent experience may be accepted.

• Over 2 years of experience in data reporting, analytics, business intelligence, healthcare analytics, PBM analytics, or similar analytical roles.

• Practical experience in developing reports, dashboards, analytical queries, and business insights using SQL and at least one modern BI or analytics platform.

• Advanced SQL skills, including joins, aggregations, common table expressions, window functions, stored procedures, performance tuning, and validation of complex query logic.

• Familiarity with modern data platforms such as Snowflake, SQL Server, Azure Synapse, Databricks, BigQuery, Redshift, or similar cloud data warehouse/lakehouse technologies.

• Working knowledge of NoSQL or document-oriented databases like MongoDB.

• Proficiency in business intelligence and visualization tools such as Power BI, Tableau, Domo, Looker, or similar platforms.

• Strong Excel capabilities, including pivot tables, advanced formulas, data validation, and ad hoc analysis.

• Working knowledge of Python, R, or similar tools for data preparation, statistical analysis, automation, and exploratory analysis.

• Understanding of AI-enabled analytics, natural-language query tools, automated insight generation, and responsible AI usage in a healthcare data context.

• Familiarity with data governance, data quality, metadata, lineage, metric definitions, and documentation standards.

• Ability to handle large datasets, APIs, SFTP/FTP file exchanges, vendor data feeds, and recurring data pipelines.

• Excellent written, verbal, and visual communication skills.

• Knowledge of PBM, healthcare, pharmacy claims, eligibility, benefit design, formulary, prior authorization, or claims adjudication data is preferred.

• Availability to work core hours from 8:00 AM to 5:00 PM CT, with adjusted hours for meetings across all time zones.

• Willingness to work extended hours, weekends, and holidays as required by industry demands.

• Minimal travel is expected.

🏝️ Benefits

• Medical, Dental and Vision Insurance

• Disability and Life Insurance

• Employee Assistance Program

• Remote Work Options

• Generous Paid-Time Off

• Annual Reviews and Development Plans

• Retirement Plan with company match immediately 100% vested