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Senior Data Analyst, Clinical Outcomes - Remote

Posted 4 weeks ago
Brighton Health Plan Solutions logo

Brighton Health Plan Solutions

Data Analysis
Full Time
USA

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Overview

The Senior Data Analyst, Clinical Outcomes will be an analytically driven team player, responsible for understanding business needs and objectives, eliciting requirements from stakeholders, and analyzing data and processes to identify opportunities for improvement. This role will support BHPS Clinical Programs, Utilization Management, Complex Case Management, and Population Health Management. As Senior Data Analyst, Clinical Outcomes, you will be challenged to think creatively while developing actionable insights to inform client and program strategy.

In Short

  • Monitor Utilization Management and Case Management activities through the identification and development of key performance metrics and benchmarks.
  • Conduct prospective savings analyses in support of clinical program initiatives.
  • Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources, including claims and authorizations.
  • Develop algorithms for identifying high-risk members, and measure the performance of Disease Management and other Medical Management programs.
  • Develop reporting on NCQA HEDIS and other quality measures.
  • Build and maintain client-facing reports, dashboards, and analyses.
  • Lead program performance review presentations with clinical program managers, client account managers, and external clients, as needed.
  • Collaborate with Medical Management to provide ongoing support.
  • Manage internal and external client requests and timelines to ensure timely delivery.
  • Provide ad hoc analytical support as necessary.

Requirements

  • Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field.
  • 5-7 years of experience in healthcare analytics, preferably in a managed care setting.
  • Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required.
  • Proficiency in MS Excel required.
  • Experience with clinical outcomes reporting and cost and utilization analysis.
  • Experience with developing client-facing reports.
  • Ability to explain technical concepts to a non-technical audience.
  • Ability to effectively manage and prioritize several concurrent projects.
  • Excellent oral and written communications skills.
  • Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau) a plus.
  • Experience with Predictive Analytics a plus.

Benefits

  • Join a diverse and welcoming culture focused on encouragement, respect, and inclusion.
  • Opportunity to work with a team committed to improving healthcare access and delivery.
  • Engagement in innovative technology platforms and healthcare solutions.
  • Work with a company that values diversity, equity, and inclusion.

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