Senior Health Plan Operations Analyst

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

📋 Description

• Design, develop, and uphold dashboards, productivity trackers, and KPIs for leadership teams.

• Construct high-complexity backend data queries for dashboards and ad-hoc projects.

• Present data insights utilizing visualization tools.

• Integrate industry benchmarks into visual metrics.

• Identify, track, and communicate trends in quality and spending metrics.

• Investigate, triage, document, and resolve data quality issues from both internal and external sources.

• Create and implement testing algorithms to assess large data streams.

• Audit year-end performance and claims data, reporting any discrepancies.

• Source, cleanse, and organize data from payer portals, Rx claims files, SFTP sites, and internal databases.

• Execute advanced SQL queries in Snowflake for data analysis and reporting quality assurance.

• Develop complex formulas and templates within Google Sheets and Excel.

• Maintain documentation on analytics, source-of-truth architectures, and peer cross-coverage strategies.

• Assist in work coordination, mentor junior analysts, and support training plans and work-product reviews.

• Act as a data subject matter expert and participate in meetings in the absence of the manager.

• Facilitate communication within departments and across functions.

• Carry out other assigned duties.

⛳️ Requirements

• Bachelor’s degree in a relevant quantitative field or equivalent professional experience.

• 4+ years of experience in data management, analysis, quality assurance, and auditing of healthcare or payer data.

• Intermediate SQL programming skills (Snowflake preferred).

• Advanced skills in Microsoft Excel and Google Sheets (complex formulas, nested functions, pivot tables).

• Strong communication abilities with effective collaboration skills across remote teams.

• Proactive approach with a demonstrated capacity to prioritize multiple tasks in a dynamic environment.

• Knowledge of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures.

• Experience with statistical software, such as R or Stata.

• Ability to sit for extended periods while working at a desk and using a computer.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Flexible work hours and remote working options.

• Opportunities for professional development and career advancement.

• Generous paid time off and holiday schedule.