Healthcare Data Analyst Resume Samples

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K Wilderman

Karley

Wilderman

6737 Buford Stravenue

Philadelphia

+1 (555) 322 0542

6737 Buford Stravenue

Philadelphia

Phone

p +1 (555) 322 0542

Experience Experience

Dallas, TX

Healthcare Data Analyst

Dallas, TX

Predovic, Russel and Smitham

Dallas, TX

Healthcare Data Analyst

Provide clear and organized written procedures to support workflow process, query design, etc to allow replication of work
Develop provider specific performance reports cards
Provide analytical support of provider performance under value based contracts
Provide implementation support to the development team for new and existing customers and serve as a liaison between development and client relations staff
Develop reports and analyze data to measure clinical outcomes, network performance and methodology levers
Creates and maintains high quality documents, and adheres to quality standards set by Management
Responsible for executing statistical analysis plans created by the statistician and/or QSV team managers

San Francisco, CA

SQL / SAS Healthcare Data Analyst

San Francisco, CA

Bosco LLC

San Francisco, CA

SQL / SAS Healthcare Data Analyst

Interface professionally with database, Datastage ETL and SAS development teams
Works with minimal guidance; seeks guidance on only the most complex tasks
Coordinate SAS algorithm development projects of varying complexity
Create technical specifications, unit test plans, dataflow diagrams
Improve operational processes
Support, train and mentor fellow analysts and developers
Perform complex data analysis to support research requests by the client

present

Phoenix, AZ

Senior Healthcare Data Analyst

Phoenix, AZ

Graham Inc

present

Phoenix, AZ

Senior Healthcare Data Analyst

present

Review work performed by others and provide recommendations for improvement
Work collaboratively with colleagues at Verscend, SHDR and HMS Operations to develop best practices around data validation, management and analysis
Liaise with external stakeholders on outward-facing data initiatives, like provider data reports, to provide basic technical assistance and solicit feedback
Develop analytics to track engagement in and cost impact of care management programs
Provide support and input to Air Methods’ legal department and executive leadership to assist in payer contract negotiation
Create cohorts to show impact of health management programming and identify cost savings at both the individual and population level
Work cross-functionally with Sales and Operations teams to provide data-driven recommendations and solutions to clients

Education Education

Bachelor’s Degree in Accuracy

California State University, Northridge

Bachelor’s Degree in Accuracy

Skills Skills

Excellent organizational skills, analytical ability, and strong attention to detail
Ability to adapt and affect change management, possess strong analytical skills, proficiency in Excel and other Office applications
Quick learner, able to apply the knowledge gained effectively and across multiple situations
Act as a team player, possess excellent communication skills, possess strong time management and multi-tasking abilities
Professional manner with the ability to speak, write and understand English
Excellent interpersonal and communication skills. Ability to deliver complex information in a clear, concise, and relevant manner
Ability to understand client operations, financial and quality data
Review and verify the quality and accuracy of other analysts’ deliverables
Knowledge of SQL-Server including stored procedures, table definitions and queries
Demonstrated ability to prioritize deliverables

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Healthcare Data Analyst Resume Examples & Samples

At least 2 years of experience managing projects focused on healthcare analytics, healthcare economics or Medicaid program integrity
Proficiency with SQL required, and one other statistical programs preferred
Some experience in healthcare analytics, specifically in creating cost-efficiency, risk-adjustment and predictive models and working with large data sets required
Skilled at applying statistical methodologies such as linear regression, logistic regression, time series analysis, longitudinal data analysis and sampling techniques
Intermediate level of proficiency with MS Word, Excel, Outlook and Access required
SaaS and Project management experience preferred

Senior Healthcare Data Analyst Resume Examples & Samples

A minimum of 6 year of experience managing projects focused on healthcare analytics, healthcare economics or Medicaid program integrity
Must be available to work on-site in Madison, WI
Experience in project management as demonstrated with a track record of delivering quality results on complex projects preferred

Healthcare Data Analyst Resume Examples & Samples

Bachelor’s degree in Healthcare/related field or Associates degree plus 2 years of industry related experience
Working knowledge of Microsoft Excel and PowerPoint
Basic understanding of Healthcare Industry
Ability to manage multiple projects
Effective communication skills both oral and written
Health-related coursework (Nursing, Epidemiology, Health Business, MPH, etc.)
Previous healthcare industry experience
Previous experience with Microsoft Access and Visio
Knowledge of CPT and HCPCS coding

Healthcare Data Analyst Resume Examples & Samples

Develop innovative approaches to manipulate data sets in a way that enables us to see trends and patterns
Perform data mining and analysis that impacts pricing and risk assumptions
Create and review monthly/quarterly claims information and summarize for client reports
Prepare proposal and renewal exhibits along with Account Manager
Review and analyze summary from carrier to confirm renewal is in line with claims history
Prepare and summarize arguments to be given to Account Manager to negotiate with carrier for competitive rates
Support Account Manager in negotiation with carrier underwriter
Assist benefits department with analysis reporting
Perform additional responsibilities as assigned

Healthcare Data Analyst Resume Examples & Samples

Conduct research in order to determine compliance with relevant Medicaid or other government health program regulations
Assist with performing various analyses relating to Medicaid engagements, including the analysis of medical claims data
Prepare written documents supporting professional decisions and perform other types of related tasks involving health care provider quality incentive programs
Review applicable federal and state Medicaid policies and regulations relating to health care reimbursement and quality incentive programs
Demonstrate excellence in communication skills, data gathering including medical claims, analysis, reporting, and process improvement

Senior Healthcare Data Analyst Resume Examples & Samples

Develop, update, and maintain production code used to calculate performance measurement results and improvement targets according to measure and program specifications on prescribed production cycle
Perform patient assignment logic queries for prescribed patient attribution algorithm
Monitor and trend performance measure results, including but not limited to those that are chart-abstracted results for hospital-calculated measurements, reporting partner-calculated measurements, and administrative claims based pay-for-reporting and pay-for-performance measurements
Perform detailed administrative claims analyses related to patient utilization, claims payment and clinical outcomes
Act as a subject matter expert for value-based purchasing and measurement tools
Ensure quality control procedures and documentation management are followed
Manage day-to-day hospital inquiries and metrics

Healthcare Data Analyst Resume Examples & Samples

Provide data and competitor analytics that enhance and drive sales strategy
Perform client research and collaborate with sales and leadership team members to determine a comprehensive view of client historical operational, financial and quality data
Analyze client data to understand historical performance relative to potential performance of DDDS products and programs, identify performance gaps and highlight performance improvement opportunities
Review analytics against Centers for Medicare and Medicaid Services (CMS) model to identify revenue potential
Develop customized client analytics reports to support sales proposal development and sales presentations
Present data analytics results that demonstrate the value of DDDS programs in comparison to other client vendor programs
Conduct competitor analyses to expand market intelligence
Prepare and communicate analytics results to support marketing, product management and product development functions
Excellent interpersonal and communication skills. Ability to deliver complex information in a clear, concise, and relevant manner
Ability to understand client operations, financial and quality data
Ability to identify data discrepancies and produce accurate data analyses
Ability to conduct competitive research
Ability to work with and empower others on a collaborative basis to ensure success of unit team
Knowledge of managed health care industry, health plans and large group physician organizations
Knowledge of CMS programs
Ability to effectively communicate with all levels of an organization both internally and externally
Excellent analytical, decision making, organizational, creative problem solving, verbal and written skills are required
High level of proficiency in use of existing software packages and data analysis tools (PowerPoint, Excel, Microsoft Word, etc)
Ability to work independently within a team environment with multiple priorities

Healthcare Data Analyst Resume Examples & Samples

Importing and interpreting source data
Scrubbing, cleaning and validating data
Preparing input files for 3rd party data processing
Analyzing the data results and making changes if needed, before presenting the data to project managers and internal consultants
Perform ad hoc T-SQL programming and analysis
Build ETL processes for client projects
Design, develop, and implement modifications on several web based applications
Develop custom reports using Microsoft Reporting Services
Review of peers work product to validate quality results
2+ years - experience with SSIS, SSMS, and SSRS required
2+ years - experience in transact SQL required (T-SQL assessement testing required for all candidates considered for an interview)
Able to interpret, scrub, process, and explain data
Proficiency with Microsoft Office Suite, especially Excel
Someone with a well-rounded IT background
Analytical thinker, able to assess problems logically
Strong communication skills and experience working with a team
Detailed and organized

Healthcare Data Analyst Resume Examples & Samples

Bachelor’s Degree in Finance, Economics, Math, Statistics, Public Health, Informatics or a related field (Strong Math/Statistics background)
Intermediate database querying (SAS and/or SQL) and data analysis skills
Intermediate Microsoft Excel data analysis skills: PivotTables, VLookups, Charts/Graphs
Knowledge of healthcare or health insurance, specifically Medicare/Managed Care
Familiarity with Medicare Advantage program, risk adjustment, HEDIS measures, and Accountable Care Organization (ACO) Shared Savings program
Experience creating financial projections and modeling

Senior Consultant, Healthcare Data Analyst Resume Examples & Samples

Collect and analyze data on health care markets, competitors and health plan performance; contribute to design of project analyses
Interact with client staff to collect information and conduct interviews. Participate in/lead project team discussions of the conclusions and direction of analytical work
Present findings within the project team and to partners and internal clients; participate in/lead project team discussions of the conclusions and direction of analytical work
Lead mid-size projects and components of larger projects
A minimum of five years of experience as an informatics specialist addressing clinical and/or health policy issues in health care
An advanced degree (MA or higher) in Statistics, Biostatistics, Economics, or a Scientific field related to health care
Formal training in advanced quantitative techniques including linear modeling, time series analysis, and non-parametric estimation techniques
Experience working with large data sets and resolving data management , integration, and validation issues
Proficiency in SAS and SQL programming; familiarity with “R” and/or STATA a plus
Proficiency in Microsoft Office products (Excel, Word, PowerPoint)
Effective communication skills (written and oral) in dealing with all levels of staff and management
Ability to develop appropriate hypotheses and design studies to effectively validate those hypotheses
Ability to develop presentation slides and make presentations within a project team and to partner in presentation development with internal staff
Ability to verbally communicate research findings to a non-technical audience
Ability to teach fellow research staff how to appropriately analyze health care data

Healthcare Data Analyst Resume Examples & Samples

Supports the implementation of Partners system wide performance incentive program, including payer contract report validation, internal budget forecasting and financial settlements
Produces monthly financial reports to assess Partners system performance on internal efficiency, quality and program based goals
Supports internal population based medical management data efforts by performing the clinical and cost based analysis of medical and pharmacy claims and EPIC data using SAS. Population data include Commercial, Medicare and Medicaid
Uses knowledge of claims payment methods and policies employed by local and government payers to support global risk contract implementation. Supports quarterly and settlement validation of global risk contract results
Develops expertise with population based s/risk adjustment tools
Identifies data and programming issues affecting performance reporting and works with cross functional departments to resolve problems
Responds independently to routine internal reporting inquiries and ad hoc data requests
Supports the maintenance of relevant PHM reporting applications for EDW and identifies monthly payer data feed issues
Minimum of 3 years related healthcare experience, preferably with a payer or integrated healthcare system
Experience working with financial models preferred
Expert proficiency in MS Excel, MS Access
SAS experience required
Experience reading and interpreting payer contracts and payer reimbursement policies a plus
Excellent interpersonal skills, including strong customer service orientation
Ability to work effectively and efficiently as a member of a team
Self-motivated, resourceful, and able to take initiative

Healthcare Data Analyst Resume Examples & Samples

Use a large and growing enterprise data warehouse to track, evaluate and report on the impact of health care delivery innovations
Construct analytic files and the variables necessary to address program impact and operations
Conduct appropriate exploratory and descriptive data analysis
Draft and edit reports, presentations, and correspondence to internal stakeholders, and Partners leadership
Producing timely and accurate monthly and quarterly reporting to Key Stakeholders within Partners
Improve visualization of current reports using existing tools
Assist with presentations of findings and make recommendations to internal and external stakeholders/leaders as needed for assigned projects
BS/BA or equivalent required, preferably in mathematics, epidemiology, statistics / biostatistics, economics, or health policy / health services research
Strong quantitative, analytic, and technical skills relating to data management, analysis, and presentation, preferably in healthcare
Experience with healthcare claims data and payment policies strongly preferred
Minimum 3 + years experience in detailed analytics and reporting, preferably in healthcare
Experience programming in SAS or SQL required
Thorough knowledge of MS Excel, MS PowerPoint, and other statistical programming languages a plus
Strong data cleaning, manipulation skills, and analytic skills
Ability to interact with senior Partners leadership
Understanding of the health care environment and an interest in healthcare innovation a plus

Healthcare Data Analyst Resume Examples & Samples

Work with a variety of tools (ex: SAS, SQL, Excel, Qlikview, etc) to access data, write queries, develop programming logic, run reports, manipulate, and analyze large datasets to meet the needs of Partners Clinical Analytics
Responsible for completing thorough quality assurance procedures ensuring accuracy, reliability, and validity of work
Collaborate with key internal stakeholders to gather and analyze specific needs and requirements
Retrieve, organize, and manipulate data from the Enterprise Data Warehouse and other databases. This will require basic and advanced programming to prepare data for reporting and analysis
Present analytical findings in a variety of formats (reports, PowerPoint, graphs, figures, tables, formulating recommendations, and effectively presenting results to non-analytic audiences
Provide clear and organized written procedures to support workflow process, query design, etc to allow replication of work
Complete other special projects as needed
B.S. Degree in Healthcare, Mathematics, Computer Science, related field, or relevant experience
Experience using and synthesizing large transactional databases and data warehouse, clinical and claims data strongly preferred. Experience working with ICD codes, DRGs, MS-DRGs, APR-DRGs and CPT codes a plus
1 year of experience with SAS and/or SQL query writing
Strong aptitude for analytical thinking and demonstrated data skills
Proficiency in MS Excel required
Experience with HEDIS, quality-based healthcare measurement programs, or other healthcare data analysis preferred
Excellent organizational skills, analytical ability, and strong attention to detail
Ability to work independently, manage multiple tasks and projects, and meet deadlines. Ability to flex within a dynamic organization/policy environment
Proven ability to assume sole and independent responsibility for multiple projects from identification through to resolution
Ability to handle sensitive information
Ability to communicate information to technical and non-technical audiences

Senior Healthcare Data Analyst Resume Examples & Samples

Develop and maintain analysis plans and timelines in consultation with analytic teams and biostatisticians
Work with investigative teams to appropriately to plan and conduct higher level statistical modeling
Construct analytic files and the variables necessary to address the research questions
Collaborate with data analysts tasked with evaluating specific population health strategies to ensure that research findings build on and are consistent with programmatic findings
Manage and fulfill requests for analytic research files that will be used by research fellows and collaborating investigators
Maintain IRB protected project data
Draft and edit reports, presentations, and correspondence to internal stakeholders, senior faculty collaborators, and Partners leadership
Summarize and present research methods, findings, and observations / conclusions externally as reports, manuscripts, posters and oral presentations in collaboration with investigative teams
BS/BA or equivalent required, Masters in biostatistics or epidemiology preferred
Strong quantitative, analytic, and technical skills relating to data management, analysis, and presentation
Familiarity with claims data, payment policies, and health care evaluation preferred
Three or more years of experience as a data analyst / epidemiologist
Strong analytic skills; ability to turn data into information
Strong data cleaning and manipulation skills
Thorough knowledge of MS Excel, MS PowerPoint, and SAS
Strong oral and written communication and organizational skills
Ability to manage multiple projects simultaneously, set priorities, and collaborate with team members and others throughout the organization
Solid understanding of the health care environment and an interest in primary care innovation a plus

Healthcare Data Analyst Resume Examples & Samples

Familiarity with health care claims data, payment policies, and health care evaluation preferred
Experience programming in SAS required
Ability to interact with senior faculty from diverse disciplines, as well as senior Partners leadership

Healthcare Data Analyst Resume Examples & Samples

Reports to the IT Director
Assessing and interpreting business partner's and customer's reporting needs and requirements
Investigates non-standard requests and problems
Designing and implementing scalable analytical methodologies and reporting solutions
Querying data sources to support their initiatives
Scrubbing and monitoring data to make sure that it meets legal requirements
Maintain, monitor and execute against the data transfer schedule and goals
Uses pertinent data and facts to identify and solve a range of problems relative to HIPAA, ARRA and data release
Provides explanations and briefings to colleagues on topics related to analytics and data transfers
This position can include client-facing aspects and should be someone who is comfortable and has experience working directly with clients to gather requirements, digging into data and present findings back to a client based upon the original request
Understanding of health care medical and pharmacy claims data manipulation and analysis
Strong analytical and problem-solving skills and ability to interpret results of query analyses
Experience in large complex systems, including a solid background in systems implementation in multiple environments

Healthcare Data Analyst Resume Examples & Samples

Create Benchmark reporting – standard and ad hoc needs
Anticipates customer needs and proactively develops solutions to meet them
Serves as a key resource regarding book of business data and issues
Perform quality review of output provided
Provides explanations and information to others on the most complex issues
Demonstrated ability to prioritize deliverables

Healthcare Data Analyst Resume Examples & Samples

Create, enhance, and maintain budget or financial planning models, surveys, benchmarks
Evaluate, interpret and analyze data and business process and analyze / monitor new, routine and ad hoc reports
Provide support when compiling and reporting information and assume responsibility for data integrity among various internal groups and / or between internal and external sources
Support short term operational activities
Ability to adapt and affect change management, possess strong analytical skills, proficiency in Excel and other Office applications
Act as a team player, possess excellent communication skills, possess strong time management and multi-tasking abilities
Bachelor’s degree in Business, Finance, Health Administration or related field
1+ year of experience in business / finance analysis collecting, analyzing, and presenting data and recommendations to management
Demonstrated process improvement, workflow, benchmarking and / or evaluation of business processes
Experience in SQL and SAS

Healthcare Data Analyst Resume Examples & Samples

Produce sophisticated code and sound statistical reports
Assist in market research data collection process
Efficiently work independently in a multi-task environment

Healthcare Data Analyst Resume Examples & Samples

Knowledge expert on how to best utilize Verisk for our clients
Responsible for designing how to utilize the capabilities for campaigns, reporting, interfacing, with engagement engine
Oversight and guidance for client in-sourcing results analysis and training
Identify population health opportunities (including anomalies in data unique to each client)
Running canned Verisk reports and determining what additional analysis opportunities are available with the client’s population
Developing new queries to track programs over time
Assessing performance of vendors (DM, CM, etc.) within the application
Ability to create cohorts, show impact, and identify cost savings based upon both the individual and population level
Create various benchmarks by industry and market using data provided in Verisk tool
Create baseline reporting to first guide clients in correct direction
Slice and compare subsets of data within clients BOB to demonstrate innovation and ‘think outside the standard healthcare box’ in order to target short term changes, to go along with the long-standing programs already in place
Cross reference various other systems used in nurses workflow to demonstrate true clinical value and savings, quickly pin pointing key areas
Create standard report package templates according to clients’ needs and clients’ industry
Incorporate predictive risk modeling to help drive client wellness program initiatives
Work towards an average pricing resource tool in order to show more accurate soft savings
Identify clinical trends and tracking intervention / activity results
Summarizing clinical findings, options, and recommendations
Proven experience working with multiple projects and collaborating with diverse resources to meet tight delivery timeframes. Must be organized, detail oriented, accurate and responsive
Quick learner, able to apply the knowledge gained effectively and across multiple situations
Critical thinking skills and ability to solve problems; detail-oriented with a high degree of accuracy and follow through
Bachelor’s degree in technical and/or analytical program
Prior work experience to include 50% data analyst / 25% healthcare / 25% industry knowledge

Senior Healthcare Data Analyst Resume Examples & Samples

Lead analyses and produce standard reports using healthcare claims data (in particular, with regards to quality) which support the development, implementation, and monitoring of ACO and other MassHealth programs
Manipulate and build datasets from claims and encounter data to support analyses through use of efficient SAS/SQL code
Liaise with external stakeholders on outward-facing data initiatives, like provider data reports, to provide basic technical assistance and solicit feedback
Plan, organize, and direct project team meetings
Mentor junior analysts
Proficient in SAS and/or SQL, ACCESS, and other data manipulation tools
Strong critical thinking and programming skills
Knowledge of health care terminology and use of diagnoses, revenue codes, etc
Experience working with actuaries, clinicians, health policy experts, and other subject matter experts
Masters’ degree in a public policy, public administration, public health, economics, health care administration, epidemiology, statistics or a related field
Knowledge of the Massachusetts health care industry and market dynamics
Ability to prioritize numerous tasks, under time constraints, and changing priorities

Senior Healthcare Data Analyst Resume Examples & Samples

Independently perform various complex analyses and audits relating to Medicaid or other reimbursement-related engagements, with a focus on identification of fraud, waste, abuse or misuse of Medicaid or other payer funds
Develop and maintain general knowledge of Medicaid and/or other payer statutes, regulations, provider billing manuals and other healthcare reimbursement policies
Review applicable Federal and State Medicaid policies and regulations relating to healthcare reimbursement including alternate payment methodologies
Conduct research to determine the standards applicable to billing compliance with Medicaid or other government program regulations
Review, summarize, and apply policies and regulations to specific analyses, reviews and audits
Interpret and analyze healthcare data, to include review and analysis of medical, financial or other records, to identify inconsistencies, anomalies, abnormal billing patterns and other indicators of suspected fraud, waste or abuse (e.g. services not rendered, up-coding, un-bundling, etc.)
Work cooperatively and constructively with team members, including mentoring, training and assisting team members as required
Evaluate business processes to identify opportunities for improvement
Work within the defined scope of assigned projects

SAS / SQL Healthcare Data Analyst Resume Examples & Samples

Engage with Internal clients to clearly define business requirements
Interface professionally with database, Datastage ETL and SAS development teams
Perform complex data analysis to support research requests by the client
Follow quality assurance guidelines including the documentation, review and approval of all project related artifacts
Coordinate SAS algorithm development projects of varying complexity
Improve operational processes
Function well within a matrix organization (E.g. – supporting multiple leaders)
5+ years of IT Business/System Analyst experience
3+ years of Healthcare experience
3+ years writing SQL query experience
3+ years relational database experience
UNIX SAS development experience
Undergraduate Degree
Overpayment Recovery experience (Data Mining , COB, FWA)
Knowledge of healthcare claim adjudication systems

Healthcare Data Analyst Resume Examples & Samples

Hands on data analytics
Learn and apply innovative techniques to large claims datasets to analyze a wide array of healthcare-related topics
Create and prepare exhibits summarizing our findings for client delivery

Healthcare Data Analyst Resume Examples & Samples

Designs and enhances databases
Designs menu systems that are effective and user-friendly
Develops reports with accurate, easy to read, useful information
Designs and generates tracking and monitoring tools
Participates in the development of outcomes and process measures, including technical specifications, to enable population measurement, guideline implementation, and evaluation
Builds and maintains complex statistical routines using macros, vendor software, and software written by self and others
Tests and maintains data integrity across multiple databases (internal SAS, DB2, VSAM; external: Adobe, Excel, SAS parsing routines, COBOL)
Builds sophisticated statistical models and forecasting tools using these databases
Defines and frames complex multi-dimensional healthcare issues and develops time tables/processes for decision making
Translates needs, issues, and ideas into effective strategies and action plans
Formulates specific implementation plans and evaluates the effectiveness of actions/programs implemented
Develops creative alternative solutions
Works closely with IT and outside partners (and physicians for TPMG departments)
May coordinate team/project activities and schedules
May assist in the determination of goals and priorities with team, clients, or project management sponsors
May provide leadership to multi-disciplinary project teams
Communicates results/recommendations to project sponsors, clients, and various senior level audiences (including physicians for TPMG departments)
Minimum three (3) years of programming in SAS, SQL, VBA, .net or equivalent statistical analytical programming language
Minimum of three (3) years of related analytical consulting experience
High School Diploma or General Education Development (GED) required
Analytical consulting experience in the healthcare field

Healthcare Data Analyst Resume Examples & Samples

Design, develop, and implement modifications on several web based applications using C# and other technologies
2+ years - Application development and technologies – C#, VB.NET, XML, Visual Studio .Net, .Net Framework, SharePoint
2+ years - experience in transact SQL required

Senior Healthcare Data Analyst Resume Examples & Samples

Gather and analyze business requirements
3+ years of experience in health care payment integrity analytics and working with large data sets
1+ years’ experience Maintains working knowledge of medical coding concepts (CPT, ICD-9 / 10 coding, HCPCS and DRGs)
1+ Advanced level of proficiency coding overpayment analytics using SQL
3+ years of full Software Development Life Cycle experience
3+ Professional IT experience in a large, enterprise environment
Medical claim coding experience / certification
Oracle PL / SQL coding experience

Healthcare Data Analyst Resume Examples & Samples

Work with a variety of tools (ex: SAS, SQL, Access, Excel, Tableau, Visio, etc) to access data, write queries, run reports, manipulate, and analyze large datasets to meet the needs of Partners QSV
Responsible for executing statistical analysis plans created by the statistician and/or QSV team managers
Retrieve, organize, and manipulate data from multiple sources (ex: databases and data warehouses). This will require basic and advanced programming to prepare data for statistical analysis
Collaborate with QSV A&R team to co-support projects, perform quality checks, and assist with meeting deadlines
Support QVS teams as needed, including (but not limited to): data reporting, dashboard development, marketing updates, quality website data refreshes, evaluation of publicly reported data, proposed new measures, modifications to existing measures, etc
Assist with flow of data to/from vendors and affiliates, support updates/uploads, and QC data provided by vendors
Support the development, modification, and validation of new and existing quality measures as needed
Perform comprehensive literature reviews of existing quality measures, clinical best practices and recommendations and synthesize relevant information
Participate in training sessions as required to execute job responsibilities
Assist with preparation and delivery of presentations as needed
Provide learning opportunities for PHS staff through learning seminars on statistical methods/quality measurement
The ideal candidate will possess a Masters Degree in Public Health, Epidemiology, Biostatistics, or Computer Sciences, with advanced education/training in data programming and/or statistics
2+ years experience working as a programmer/data analyst, preferably in a healthcare setting
Experience working with large data warehouses is strongly preferred
A minimum of 1+ yrs experience working with healthcare data is strongly preferred
Proficiency with programming languages and statistical software (SQL and SAS) is required
Must be an experienced programmer able to write complex codes and generate queries/reports with limited guidance
Advanced user of Microsoft Excel, Access, Word, and PowerPoint is required
Experience with data analysis and reporting, and working knowledge of data visualization software is preferred
Strong understanding of data structure/integration and relational database design
Some (2+years) experience working with integration of multiple data sources from databases/data warehouses
A basic understanding of quality measurement and quality improvement methods is favorable
Professional demeanor; maintain strict confidentiality, use a high level of discretion and demonstrate sound judgment
Motivated, organized, detail oriented, and deadline driven
Good problem-solving skills to identify issues and determine when to seek additional guidance
Ability to set priorities, coordinate multiple tasks, and work well under pressure
Ability to carry out responsibilities accurately and independently, as well as work effectively within teams
Strong communication (oral, written, interpersonal) and organizational skills
Ability to work with diverse audiences

Healthcare Data Analyst Resume Examples & Samples

5+ years related experience with healthcare and insurance data
Bachelor’s degree in health informatics, computer science, statistics or mathematics
Ability to analyze data from a health perspective
Strong experience with identifying data and information requirements for business intelligence and analytics
Proficient in the use of computers and programs that specialize in data collection and data management
Proven ability to extract/source data from multiple data sources and integrate them into a single source view/report/dataset
Demonstrate acumen in data profiling and data modeling
Ability to communicate with business users and translate business requirements
Ability to dissect and learn applications and database solutions
Ability to work independently on projects with minimal direction
Smart and Agile
Excellent Communicator
Analytical Thinking

Healthcare Data Analyst Resume Examples & Samples

Review the analysis and interpretation of others work
Oversee ad - hoc client and operational reports developed and presented by others
Support short and long term operational / strategic business activities through analysis
Support short and long term operational / strategic business activities by assisting in the development, execution, management and maintenance M&R, CMS Star ratings and coding accuracy improvement strategy and performance
Develop and implement effective / strategic business solutions through research and analysis of data and business processes
Research and report market and provider specific performance drivers
Document / Communicate root causes affecting performance
Develop and determine effective strategies for local market initiatives
Coordinate and support local market Star and coding accuracy strategy including both national and local initiatives
Provide analytical support of provider performance under value based contracts
Develop provider specific performance reports cards
Document / communicate and drive network strategy initiatives
Determine and track financials implications of network initiatives, ROIs, remediation dollars, etc
Provide support to drive identified provider specific medial cost trend analysis
Coordinate multiple work streams including clinical, network, health care economics to drive effective solutions to potential areas for medical cost improvements
Document / communicate key milestones for effective strategy execution
Determine and track performance of the financial implications of specific initiatives
Extract key elements for data analytics and reports for Provider practices and colleagues
Bachelor’s Degree (Master’s preferred)
5 years of experience in business / finance analysis
4 years of experience working within a managed care organization, health insurer, or as a consultant (Network development / contract management analysis and working knowledge of CMS Star Ratings and HEDIS Measures)
Intermediate level of proficiency with reimbursement methodologies such as RBRVS, ASC groupers, APCs, per diems, case rates, DRGs, fee schedules, and AWP
Intermediate level of proficiency in EMR both in an outpatient and inpatient setting
Intermediate level of proficiency in Microsoft Excel, Word and Power Point
Experience with managed care and network terminology

Senior Healthcare Data Analyst Resume Examples & Samples

Knowledge expert on how to best utilize Verscend for our clients
Utilize Verscend Medical Intelligence modules to generate reporting packages that describe health care cost, cost drivers, disease prevalence, pharmacy trends and population health opportunities
Summarize clinical findings and make preliminary recommendations for clinician review
Work collaboratively with clinical staff to design and implement ad hoc and drill-down analyses to more fully describe claims experience
Develop analytics to track engagement in and cost impact of care management programs
Create cohorts to show impact of health management programming and identify cost savings at both the individual and population level
Create benchmarks by industry and market using data provided in Verscend tool
Create and compare subsets of data within client BOB to support innovation and ‘think outside the standard healthcare box’ health management programming
Merge Verscend data with various other systems used in clinicians’ workflows to demonstrate clinical value and quickly pinpoint opportunity areas
Create standard report package templates according to clients’ needs and industry
Incorporate predictive risk modeling to help drive client health management program initiatives
Work collaboratively with colleagues at Verscend, SHDR and HMS Operations to develop best practices around data validation, management and analysis
As needed, present analytic findings to senior management and clients
Bachelor’s degree in technical and/or analytical field
Minimum three (5) years relevant work experience in healthcare, health insurance, benefits administration and/or health promotion industries
Knowledge of Healthcare claims data preferred
Prior experience presenting analytic results preferred
Extremely savvy with systems, applications, and data
Expert proficiency with Excel
Experience working with multiple projects and collaborating with diverse resources to meet tight delivery timeframes. Must be organized, detail oriented, accurate and responsive
Excellent interpersonal and time management skills
A self-directed team player: collaborative, seeks input, accepts and incorporates feedback from others, freely offers assistance and is able to provide results with minimal supervision
Professional manner with the ability to speak, write and understand English
Ability to recognize complex problems, analyze situations and provide suggested/implemented resolutions
Ability to clearly present analytic findings to a variety of audiences

Senior Healthcare Data Analyst Resume Examples & Samples

Collaborates with chief medical officer, scientists, nurses, physicians, and leadership to create analytic reports for population health management using medical and pharmacy claims and electronic medical record data
Creates, tests, and maintains SAS and/or Vertica SQL programs for reporting, data analysis, statistics, and predictive modeling
Learns to develop reports in Tableau or Business Objects
Captures, cleanses, transforms and models data to provide insight and actionable recommendations
Develops and implements algorithms for performing predictions
Applies appropriate tests to analytical results to provide high quality and accurate results
Directly assists in the tie-out process of data sent to Beacon Health, LLC by external vendors. Includes working directly with the external vendors to understand the business rules application to the data extracts
Researches and reviews benchmarking data for comparison, validation and scope. Identifies areas for greatest opportunity for intervention
Creates written narrative summaries that outline project purpose, methodology, summary of findings, trends of interest, opportunities for intervention or consideration, changes or shifts in data elements from one time period to another, etc. to compliment many of the above reports, models and analytics
Provides technical, analytical and business guidance to other team members and other departments with Beacon Health, LLC
Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Presents ideas and information in a manner that gets others' attention
Works independently in a dynamic environment, with accuracy, appropriateness, and attention to detail
Treats people with respect; inspires the trust of others; upholds organizational values
Exhibits confidence in self and others; Inspires and motivates others to perform well; Accepts feedback from others; Gives appropriate recognition to others
Results-oriented, strong collaboration, problem solving and negotiation skills
Handles sensitive and confidential information, regularly exercises discretion and judgment
Ability to think strategically, analyze issues and develop recommendations
Must possess a comprehensive understanding of operational processes and ability to evaluate impacts on data compilation and reporting
Practical experience with a defined project management methodology and tools. Knowledge of existing and evolving information technologies. Practical experience working with and leading multidisciplinary work teams

Healthcare Data Analyst Resume Examples & Samples

Bachelor's degree in informatics, data management, information technology, or other related field from an accredited institution
This position requires extensive, diverse and progressively responsible experience, including direct responsibility for data analysis, programming, and data extraction
Minimum four (4) years of progressive programming experience using various data extraction and mining tools/products
Experience using full SQL capabilities and comprehension of efficient SQL data warehouse access
Previous experience with Clarity, Tableau & DB extraction
Coding experience (C#, PHP & .net) to build reporting systems is beneficial
Dashboard Design & Deployment (Visual Basic & JavaScript) experience is highly desired
Strongly prefer knowledge of and experience with health care data subject areas
Knowledge and experience with different platforms, healthcare systems and analytical tools
Ability to work with clinicians and improvement teams in the interpretation and application of information
Ability to support and execute simple to moderately complex analytic projects for a broad array of health care issues, across disciplines and functional areas
Must be able to comprehend and perform basic DBA functions including design of normalized relational database tables
Highly developed critical thinking, troubleshooting and problem solving skills

Healthcare Data Analyst Resume Examples & Samples

Be creative in interpreting the data in ways that are both diagnostic of the quality of care and outcomes, and predictive of opportunities to improve
Work with Acadia’s departments to capture data from Acadia’s various systems (HRIS, risk management, patient accounting, patient experience, etc.)
Validate the quality of the captured data
Decipher the date for comparison
Create a interface for clinicians and support staff to understand the data and its implications (e.g., trending, dashboarding, graphical presentation)
Work with Acadia’s Compliance and Clinical Services staff to innovate ways of interpreting data
Maintain the interface that translates the data
Twenty five pecent (25%) of time will be working with the Chief Compliance Officer to manage investigations of compliance and clinical matters raised through Acadia’s compliance hotline and other avenues
Experience in healthcare analytics
Ability to manage projects and deadlines
Ability to engage with others in a team environment
Independent judgment
Decisiveness
Ability to present information clearly and concisely
Ability to respond to inquiries or complaints
Ability to define problems, collect data, and draw valid conclusions
Good communication skills, written and oral
Six Sigma or Lean certification preferred

Healthcare Data Analyst Resume Examples & Samples

Acts as the liaison between business owners and IT: In addition to the partnership with application SMEs, the data analyst will also partner with other roles including Architects, and Metadata analysts to ensure enterprise data capture needs are met. Works closely with systems analysts to ensure functional specifications are properly accounting for business needs. Facilitates meetings, as necessary, to review captured business needs and obtain approvals
Identify and document data findings: The data analyst will work closely with healthcare data to determine restricted elements across application data sources using various profiling tools. A good understanding of HIPAA is essential to identify restricted data
Transfers knowledge to team: provides documentation that can be referenced for cross-training and issue resolution
Proven ability to analyze data from a health perspective
Ability to document processes and findings is essential to be successful in the role
Excellent communication skills are a must as the analyst will be required to interface with application SMEs and present findings
Clear understanding of agile software development methodologies and key best practices
SQL

Hdms Senior Healthcare Data Analyst Resume Examples & Samples

4+ years practical work experience in working with medical claims, pharmacy, or eligibility data or systems
Strong interpersonal skills. Demonstrated ability to work within a team
Strong data analytical and problem resolution skills
4+ years of practical work experience in SAS programming
Solid knowledge of ETL tools and processes
4+ years of SQL practical work experience with data queries
Ability to achieve deadlines and to set and achieve goals

Healthcare Data Analyst Resume Examples & Samples

Provide data analysis, verification, and load mapping of customer financial and clinical healthcare data related to medical, RX, eligibility, biometric and other types of data files
Mapping of raw customer financial and clinical healthcare data into standardized format using an application user interface
Research data issues and provide written business requirements for resolution
Provide implementation support to the development team for new and existing customers and serve as a liaison between development and client relations staff
Work with internal teams such as Delivery, Customer Management and development staff to evaluate, prioritize and execute development initiatives for new and existing customer data loads
Serve as the subject matter expert on the development team
Provide internal training to the engineering staff on Benefitfocus products and services
Analyze, explain and draw logical conclusions based on complex data from multiple content areas
Design and manage complex systems and processes efficiently
Responsive to any data indicating a customer opportunity or change in customer needs
Set an example of excellence as a Benefitfocus representative enhancing the company’s image and reputation through own credibility, preparation, and commitment
Identifies & works effectively with key stakeholders on complex cross-team or work group projects or problems
Uses flawless discretion and judgment in discussing information about Benefitfocus with people outside the company
Demonstrates ability to change direction in response to changing work situations
Knowledge of SQL-Server including stored procedures, table definitions and queries
Must have the ability to clearly articulate ideas and concepts both in written form and verbally
Must have excellent problem-solving skills and a keen eye for details
Must have an expert end-user knowledge of Microsoft Office suite, especially Excel and Word
Encourages and reinforces action-taking and decisiveness in others
Must have a demonstrated ability to carefully assess and accommodate detailed project requirements
Direct experience in healthcare finance or healthcare benefit plan administration
Healthcare insurance knowledge/experience including Self Funding and Fully Insured plans is preferred
Prescription Benefit Management (PBM) knowledge/experience is a plus
Experience in Healthcare data analysis, systems analysis, software implementation, software development, or technology customer service
Bachelor degree in MIS, IT Engineering, Business or related field preferred; or equivalent experience
Follow established processes to ensure data is complete and accurate upon receipt
Follow established processes to map data properly for integration
Meet or exceed targeted timing metrics for mapping documents
Meet or exceed targeted accuracy rates for mapping documents
Open Enrollment Success: Drive project planning to ensure dates are met and exceeded for all OE targeted customers

Senior Healthcare Data Analyst Resume Examples & Samples

Anticipate customer needs and proactively develop solutions to meet them
Provide explanations and information to others on the most complex issues
Intermediate level of proficiency in performing financial impact analysis, risk management, and data manipulation
2+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling
Beginner SAS (BASE or EG) experience for working with large datasets, however not looking for a strict SAS programmer. The ideal candidate would be able to use SAS to assist in developing business analytics, and also be strong analytically
Beginner level proficiency in MS Access
Experience with provider payment methodologies and healthcare products
3+ years of analytical experience in financial analysis, healthcare pricing, network management, healthcare economics, insurance claims or related discipline

Healthcare Data Analyst Resume Examples & Samples

1 – 3 years medical claims experience (professional and facility preferred)
Proficient with numbers
Proficient with analyzing and understanding report discrepancies
Proficient in using Microsoft Excel to manipulate data for correcting discrepancies
Identify pricing parameters for comparison purposes
Microsoft Access knowledge preferred
Preferred knowledge of CPT codes and revenue codes
ICD 10 knowledge a plus
Associate's degree and 5 years related experience in insurance, and multi-line claims adjusting
Licensed or certified in all states in which claim oversight and direction is being provided

Healthcare Data Analyst Resume Examples & Samples

Prepares financial and data analyses as directed. Analyzes claims, lags and reserves data as directed
Enrollment and revenue reconciliation
SOX compliance testing
Corporate standardization analysis, design and implementation
Design and implementation of financial models, scenario analysis and alternatives analysis
Assists in monthly financial statement closing including experience rebate calculation and premium reconciliation
Assists in financial operations as directed
Prepares financial models, projections and scenario analysis
Distributes automation and tracking tools to departments for monitoring operations and financial results
Assists with annual budget, re-forecasting and monitoring actual expenses to budget
Assists in required state reporting including TDI supplemental filings
Tracks membership trends and related revenue
Responsibility for financial results of assigned programs designed to increase profitability
Establishes and maintains timeliness for projects and coordinates activities with requesting internal departments or external requester to obtain specific information to meet project expectations
Develops and produces financially oriented ad-hoc reports as required
Maintains the confidentiality of all business documents and correspondence
Organizes, hosts and participates in audits and compliance reviews
Provides training for other departments and new employees on the Finance Department's role within the company, who to contact for service and finance do's and don't's
Enrollment and premium reconciliation
Must have the ability to perform Service Excellence in all interactions (Molina Texas)
Power user of Microsoft Excel
Ability to maintain confidentiality with all communications
Ability to transform and load various types of data to useable formats for Molina use
Problem solving through alternative approaches
Ability to collaborate with teams and people who may be working for other companies
Analytical ability
Must be able to function independently and to manage multiple projects and to meet established deadlines
Demonstrated adaptability and flexibility to changes and responses to new ideas and approaches
Excellent interpersonal and verbal and written communication skills
Ability to work in a distributed work environment with other people who may be supervised by external parties
3-7 years experience as Analyst/Accountant in the managed healthcare industry or related field. Must know Financial Statement formats. Demonstrated adaptability and flexibility to changes and responses to new ideas and approaches. Experience combining clinical and financial data
2-3 years Molina Analyst I experience

Healthcare Data Analyst Resume Examples & Samples

Ability to analyze and report on claims cost drivers
Ability to design and develop interactive dashboards and reports using BI tools, such as Tableau or MicroStrategy
Interface with other UnitedHealth Group businesses
Statistical modeling and segmentation
Support actuarial in pricing evaluation and other key projects
Ad hoc analyses related to claims, lives, and value added services
Ability to mine data, develop summarized reports and present results to Senior Leaders
Play support role in driving analytic strategies
Experience in the healthcare insurance industry preferred
Experience in dashboard design and development
Demonstrated capability in driving business results through statistical modeling and segmentation implementation, data analysis and reporting
Experience with BI tool such as Tableau, MicroStrategy preferred
Experience working with distributed computing tools such as Hadoop and MapReduce to analyze data preferred
Master's in Statistics or related field strongly preferred
Experience with Pig (Pig Hadoop Component) or Hive (Hive Hadoop Component)

Healthcare Data Analyst Resume Examples & Samples

Gathers and refines business requirements for reporting deliverables
Performs complex analysis and is able to explain results/trend and make recommendations
Provides analytical services for business data needs and makes recommendations for viable solutions
Proactively identifies data issues that impact deliverables
Recommends solutions to resolve issues
Works closely with Team Leads and Management to meet department needs
Creating and executes SQL queries within a relational and star schema databases for analysis and problem solving
Performs special projects and other duties as assigned and required
Bachelor's Degree (or higher) or a High School Diploma/GED with 5+ years of Data Analysis experience
2+ years of experience with business intelligence/analytic tools or programming languages used to interpret results and summarization for presentations
2+ years of experience performing Data Analytics with the ability create reports
2+ years of advanced level of proficiency with Microsoft Excel (pivot tables, charting, advanced formulas)
1+ years of healthcare analytical experience
Knowledge of Data Release Precautions and HIPAA Regulations

Senior Healthcare Data Analyst Resume Examples & Samples

Provide statistical analysis of large, complex datasets
Develop and implement statistical analysis plans to address project objectives
Effectively present statistical findings to the consulting team and non-statisticians

Healthcare Data Analyst Resume Examples & Samples

Experience creating ad-hoc reports
Experience creating custom financial reports
Bachelor's focusing Finance, Business, MIS, Economics, Statistics, etc

Healthcare Data Analyst Resume Examples & Samples

6+ years of statistical analysis or HEDIS data analysis
Must have ICD and or CPT coding experience
Advanced knowledge of Enterprise Reporting and Analysis tools, SQL knowledge is important, and Microsoft Office applications, including Excel and Access
Experience managing projects or heavy involvement in project implementation
Encounters experience preferred

Healthcare Data Analyst Resume Examples & Samples

Oversee ad-hoc client and operational reports developed and presented by others
Support short and long term operational/strategic business activities through analysis
Support short and long term operational/strategic business activities by assisting in the development, execution, management and maintenance M&R, CMS Star ratings and coding accuracy improvement strategy and performance
Document/Communicate root causes affecting performance
Document/communicate and drive network strategy initiatives
Document/communicate key milestones for effective strategy execution
5 years of experience in business/finance analysis
Intermediate level of proficiency in MS Office
Experience in Managed Care, including STARS, Clinical Documentation/Coding Accuracy, and Reimbursement coding
Experience with EMR systems (inpatient and/or outpatient)

Healthcare Data Analyst Resume Examples & Samples

Create and initiate complex data extraction and ad-hoc reports based on project objective; provide statistical analysis of results
Participate in client conversations as a subject matter expert
Develop and implement data analytics reports for routine client projects; promote consistencies and standardizations; increase the accuracy and timeliness of reporting data
Effective collaboration with a variety of project teams, management, and other internal contacts; actively engage in driving strategic initiatives for the team
Produce sound statistical findings to the consulting teams and non-statisticians
Bachelor’s degree preferably in computer science, business, economics, statistics or a math-related major
1+ years of experience in similar role with a focus in statistics and analytics (filters, unique calculations, queries, etc.) in a consulting firm or similar professional business setting
Keen aptitude in analyzing, interpreting and communicating outputs, including those of large data sets, from both internal client perspective
Capable of designing reporting outputs (with automation features)
Experience with MS Access, MS Excel, Visual Basics, SQL, Tableau, Business Objects, Crystal Reports, VBA, Macros, etc. preferred
Professional presence
Organizational and time management skills; self-starter; independent worker

Senior Healthcare Data Analyst Resume Examples & Samples

5+ years working as a Data Analyst, an Analytic Programmer, an Analytics Consultant or working in a similar capacity
3+ years of experience researching/ digging into data and performing analysis using SQL
3+ years of SQL database programming experience - OR - 3+ years of SAS experience in a relational database environment with ability/willingness to learn/use advanced SQL
3+ years of experience translating processes and algorithms into business requirements

Healthcare Data Analyst Resume Examples & Samples

Works on problems of moderate scope where analysis of situation or data requires a review of a variety of factors
Primary source to validate and reconcile general reporting data throughout the organization
Identifies discrepancies, risk and root cause for remediation
Creates and maintains reporting in compliance with the organization’s policies (CMS and FHP)
Assists in preparing required materials for appropriate parties throughout the organization
Abides by all policies, procedures, and work instructions for the reporting function of the Medicare Advantage (MA-PD) plan
Ensures data integrity is maintained throughout the reporting lifecycle
Improves efficiencies and service provided while reducing costs
Assists with preparing files and materials for internal and external regulatory audits
Implements reporting and reconciliation workflows and document processes
Pulls ad-hoc reporting as needed
Automates manual reporting and analysis of business implications and trends
May provide assistance to junior level staff with general tasks that require a better understanding of functions, as directed by immediate supervisor
Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations
Assists with various projects as assigned by direct supervisor

Senior Healthcare Data Analyst Resume Examples & Samples

Excellent verbal and written communication skills to handle external clients
Experience must include expert knowledge ofhealthcare data suchasMedical claims, pharmacy claims data
Experience in analytics using SAS
Experience working in global delivery model
Experience in creating artifacts like
Experience product life cycle
Proficient in using SAS, Excel, Tableau
Experience in Healthcare domain
Data Analytics project experience
Bachelor's degree plus 4 years of data and analytics experience
Expertise in healthcare data, SAS, business intelligence tools, population management and analytics tools highly desirable

Lead Healthcare Data Analyst Resume Examples & Samples

5+ years of experience in the Healthcare industry and familiarity with various products and lines of business
Strong quantitative ability in statistics, mathematics, or financial analysis
Experience with statistical analysis tools preferred
Hands-on experience with ETL tools such as Informatica and Datastage
Ability to develop complex SQL in an Oracle, Netezza, SAS, Teradata and/or other MPP platforms
End user experience with Informational Delivery tools such as, Cognos, Microstrategy, Tableau, and Qlikview-
Formal education and experience in hypothesis development and testing, research methods, and statistical modeling
Excellent written and oral communication skills, with a proven ability to distill complex business issues into easily understandable terms for a variety of audiences
Entrepreneurial spirit with the ability and willingness to engage in many different and simultaneous tasks
Desire to learn and mentor others via hands-on, apprenticeship model
Prior consulting or client service experience (internal or external) also preferred

Dsrip Healthcare Data Analyst Resume Examples & Samples

Participates in DSRIP PPS performance reporting meetings as requested
Maintains current knowledge of DSRIP performance reporting requirements
Collaborate closely with the Performing Provider Systems' leadership, hub partners and CHS' downstream providers on strategies to improve clinical metric outcomes
Responsible for designing and implementing processes and procedures to engage providers in better quality outcomes for patients and participate in performance improvement activities including the development and management of dashboards
Serve as the steward for all analytic and reporting needs including measure specifications, managing infrastructure to gather patient engagement, provider engagement, and performance measures data. You will function as the main contact for issue resolution and on-going communications related to DSRIP data collection, reporting and submission
Ensures integrity of data and data process. This includes investigation and knowledge of data sources and the data process flow, as well as auditing to ensure data validity and reliability
Participates in continuing education programs to enhance job knowledge as needed
Ability to use critical thinking and apply sound clinical judgment and assessment skills for decision making

Healthcare Data Analyst Resume Examples & Samples

Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients
Researching and consulting to improve healthcare data integrity and ensure excellent service delivery
Constantly improving healthcare analytical skills that are needed to perform data analysis
Resolving data enrollment issues on a daily basis
Consulting on healthcare data needs
Having exceptional time management and healthcare client management skills
Continuous development training will be provided in this role to ensure the Healthcare Data Analyst is able to exceed client expectations in this fast-paced environment

Healthcare Data Analyst Resume Examples & Samples

Gather and analyze business requirements documents
3+ years of experience programming healthcare payment integrity analytics and working with large data sets
2+ years of experience at advanced level proficiency in SQL programming
2+ years of professional experience in a large, enterprise environment
Oracle PL/SQL coding experience

Healthcare Data Analyst Resume Examples & Samples

Ensure all performance data and metrics from the participating providers are received, quality controlled and meets State expectations
Become the lead MAPP user and Salient user
Works as liaison between IT and clinical disciplines to ensure accurate communication about requested information and that the most effective and efficient data collection efforts are achieved
Supports DSRIP Project Managers with data collection, validation, analysis, presentation, and dissemination of information as requested
Employee conducts himself/herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself/herself in conformity with CHS Security Policies and Procedures

Healthcare Data Analyst Consultant Resume Examples & Samples

Develop technical specifications and design documents
3+ years of professional experience in a large, enterprise environment
Medical claim billing/coding experience or certification (AAPC / CPC)
2+ years of experience leading analytics development team (3+ direct reports)

Healthcare Data Analyst Resume Examples & Samples

Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers
Sets up process for monitoring, tracking, and trending department data
Prepares any state mandated reports and analysis
Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes
Implements and uses the analytics software and systems to support the departments goals

Healthcare Data Analyst Resume Examples & Samples

Lead analysis into key performance metrics. Discover – and then quantify – drivers and levers through collaboration with internal teams and your own data analysis. Translate your findings into what is relevant at a business level, and present to internal or external stakeholders. Your analysis will help athena make important decisions about product innovations, and will help providers optimize their business by using our products effectively
Deliver transparency into performance via monthly reports. You will translate findings from the discovery phase above into regular root cause analysis into what is driving a metric. You will uncover and quantify issues that are driving performance up or down, and work with your internal network of product experts to suggest solutions or next steps
Participate in and lead substantial research and analysis projects that span a variety of topics across athena’s operations, finance, product, and performance teams
Develop a “trusted advisor” reputation across athenahealth. Serve as liaison to internal/external stakeholders on complex industry changes such as value-based reimbursement and the transition to ICD-10
Bachelor’s or advanced degree in economics, finance, computer science, business, or a similar quantitative field. (You may even be rethinking writing that PhD dissertation.)
Minimum of 2+ years professional work experience
Experience working with large datasets
Significant experience with a least one programming language. Willingness to learn Oracle SQL quickly and at an expert level, and to learn other programming languages as needed. Experience with or willingness to learn how to navigate the Unix environment
Proven ability to work both independently on projects and as part of the larger team
Excellent verbal and written communication skills. Ability to present findings – at a non-technical level – to internal or external stakeholders. Experience communicating results to senior level clients or colleagues
Healthcare experience is not required – you will learn from A-team colleagues!

SQL / SAS Healthcare Data Analyst Resume Examples & Samples

Create technical specifications, unit test plans, dataflow diagrams
Troubleshoot client and operational issues quickly and comprehensively
Support, train and mentor fellow analysts and developers
Report project status timely and accurately from week-to-week
Function well within a matrix organization (e.g. supporting multiple leaders)
5+ years of IT Business / System Analyst experience
3+ years of writing SQL query experience
3+ years of data analyst experience
3+ years of relational database experience
Overpayment Recovery experience (Data Mining, COB, FWA)
UNIX scripting experience
File Transfer Protocol (FTP) experience

Senior Healthcare Data Analyst Resume Examples & Samples

Bachelor’s degree (Math or Statistics highly preferred) and/or at least 5-7 years’ experience in an analytics-related field
Strong technical skills in data extraction, transformation, report generation, and scenario modeling
Must have: expertise in SQL, SAS, Excel, large RDBM (eg Teradata, Hadoop, Oracle, DB2). Experience with Business Intelligence tools (eg Tableau, SAS-BI, Spotfire, Microstrategy). Applied experience with one or more of following: Unix shell, Python, Javascript, R, Unix shell
Preferred: Teradata, Tableau, Unix
Excellent collaboration and partnership skills
Keen focus on delivery (rapid turnaround, quality assurance)
Willing and able participant in prototype and proof of concept projects

Healthcare Data Analyst Resume Examples & Samples

10 years of experience with leading, directing, and managing evaluation projects
10 years of experience with healthcare program evaluation
Knowledge of HHS agencies
Possession of excellent quantitative analytic skills
PhD degree or equivalent in Social Science or a related field

Healthcare Data Analyst Resume Examples & Samples

Analyze healthcare data and information originating from various sources including but not limited to
Data generated from various clinical, survey, registry and financial databases
Clinical information regarding patient care
External sources, particularly clinical and quality performance and benchmarking metrics
Literature
EHR
Compare and contrast data both internally and externally utilizing comparative databases and benchmarking information
Perform ongoing data analysis and outcome measurement activities utilizing various tools including control charts, graphics as well as narrative analyses
Works closely with all levels of staff to determine analytic and reporting needs and ensures that requested information is created accurately and in a timely manner
Reports assigned project progress and activity as required. Maintains communication with team members and leadership
Attends and participates in appropriate workgroups and teams as directed
Develops and maintains expertise in data systems utilized to support initiatives
Maintains working knowledge of CPT and ICD-9/10 coding principles
Maintains working knowledge of operational and quality indicators as defined with industry leading best practices and regulatory bodies
Assists in developing formal presentations of analysis and recommendations to senior level audiences
Maintains high level of expertise in the LGH Information Services environment
Conducts analysis of a wide range of data sets, including operational, clinical, and financial. Synthesizes and interprets analyses
Provides technical support to clinical applications in production by, among others, developing reports, conducting data extracts, data integrity and quality control, and performing system administrative duties as required
Provides and/or facilitates end user training of clinical systems managed by the business intelligence analytics team
Serve as a resource to various hospital departments seeking guidance with performance improvement activities
Participate in functions and/or teams relative to external review agency standards
Bachelors of Science, Healthcare Administration or equivalent work experience
RN/LPN, RHIA, or RHIT
At least 5 years in the healthcare industry
Computer knowledge required in multiple software applications at a minimum MS Word, MS Excel with sophisticated knowledge of functions
Basic knowledge and understanding of ICD9-CM coding and classification systems as well as patient care reimbursement systems
Understanding of external regulatory agency requirements

Healthcare Data Analyst Resume Examples & Samples

Develop, collect, analyze, metrics and data to formulate fact-based decisions and assist in proactively implementing process improvements through the prospective and/or retrospective analysis of claim data as well as data collected from internal wellness programs
Manipulate data to provide meaningful insights
Interpret results using a variety of techniques, ranging from simple data aggregation via statistical analysis to complex data mining and visual representation
Identify and explore cost drivers
Transform raw data collected through our internal systems into actionable information
Work with program leaders to understand their information needs and help them develop an approach for their own analysis and a method to explore their data
Audit data generated
Generate standard or custom reports summarizing business, financial or clinical data for review by executives, managers, clients, and other stakeholders
Prepare ad-hoc reports as requested
Managing multiple projects and deadlines
Experience with HIPPA compliant data
Serves as a liaison between business users and department to identify strategies for evaluation of key performance indicators (KPIs), quality metrics, outcomes evaluation, population management studies, etc
Analyzes current and future end-user needs to support and improve organizational operations
Collaborates with clinical and IT staff to support defined business requirements
Maintains consistency and integrity of data collection and storage
Interfaces data from Health System hospitals for reporting purposes; develops and analyses systems needed to obtain information or statistics vital to departmental operations
Bachelor's degree in an appropriate area of specialization (healthcare, mathematics, finance, business or computer science)
Experience with data reporting and visualization software
Familiarity with data warehouses and comfortable generating reports
Bachelor's degree in an appropriate area of specialization (healthcare, mathematics, finance, business or computer science) plus three (3) years of relevant professional experience in analyzing and manipulating large
Excel (working knowledge of advanced functions and formulas), Access (reporting, SQL, backend functionality, Relational DB Concepts, Microsoft Office Suite (Outlook, Word, Powerpoint, Visio), Required
QA experience, User training, Troubleshooting experience preferred

Lead Healthcare Data Analyst Resume Examples & Samples

Lead complex analytical projects using product data and healthcare claims data
Identify, analyze, and interpret trends or patterns in complex data sets
Filter and “clean” data to locate and correct code problems
Lead analytic projects and coordinate teams of analysts and programmers to deliver on internal client needs
Work cross-functionally with Sales and Operations teams to provide data-driven recommendations and solutions to clients
Present findings and recommendations in written, visual, and oral format to stakeholders, including company executives and external clients
Provide mentoring and support to other department staff to assist in their development and ability to meet department needs
Evaluate and suggest changes as necessary to optimize processes and efficiencies
Master’s Degree in Mathematics, Economics, Information Management, Statistics, Biostatistics, Epidemiology, or Social Science, or other relevant field (or equivalent experience)
7+ years’ experience in data analytics
3-5 years’ experience in the healthcare and/or wellness space
Strong quantitative analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
Understanding of and experience with analyzing medical claims data
Expert use of business intelligence tools (SAS, SPSS, R, etc)
Proficiency in MS Office products (Excel, Access, Word, PowerPoint)
Expert at identifying appropriate analytic approaches to solve broad business challenges
Expert at presenting complex analytic methodology, results, and recommendations to diverse senior-level audiences through visual, verbal and written deliverables
Demonstrated ability to analyze, solve and interpret complex problems
Ability to prioritize and organize multiple tasks and remain focused with multiple interruptions
Highly organized and able to multitask in a rapid turnaround environment
Strong collaborative, mentoring and interpersonal skills

Senior Healthcare Data Analyst Resume Examples & Samples

Interpret data, analyze results using analytic techniques, and provide ongoing reports
Acquire data from primary or secondary data sources and maintain data systems
Present findings in written and oral format to stakeholders, including company executives and external clients
Provide recommendations on department policies, objectives and initiatives
Participate in special projects as needed or requested
BS in Mathematics, Economics, Information Management, Statistics, Biostatistics, Epidemiology, or Social Science, or other relevant field (or equivalent experience)
5+ years’ experience in data analytics
Intermediate to advanced SQL skills (experience with Teradata a plus)
Proficiency with business intelligence tools (SAS, SPSS, R, etc)
Ability to identify appropriate analytic approaches to solve broad business challenges
Proficiency in presenting complex analytic methodology, results, and recommendations to diverse senior-level audiences through visual, verbal and written deliverables

Senior Healthcare Data Analyst Resume Examples & Samples

Conduct advanced data mining as required by the program
Leads analyses and produces standard reports using healthcare claims data which support the development, implementation, and monitoring of various MassHealth programs
Manipulates and builds large datasets from claims and encounter data to support analyses through use of efficient SAS/SQL code
Utilizes strong analytic consulting skills, and a customer service focus in order to design and deliver analytic projects to client specifications
Assists in the use of qualitative and quantitative analysis techniques
Utilize and create testing measures to analyze large amounts of data
Create algorithms to test and analyze multiple, large databases
Develop analyses and present information using various tools including SAS, Business Objects, SQL and Cognos and MS Office
Independently identify and report data patterns and abnormalities
Provide analysis of key metrics and data trends
Demonstrate exceptional analytic and problem-solving skills
Test, track and monitor data for quality, integrity and trend analysis
Merge multiple databases and data sources to produce answers to complex business questions
Demonstrates attention to detail and delivers quality work products
Other responsibilities and projects as assigned
Bachelor's degree in healthcare, health business administration, public health, public policy, statistics or similar discipline; or equivalent
5 years related or equivalent experience with proficiency in Medical Claims Analysis, Financial Data Analysis, and/or Transaction-Based Data Analysis
Advanced knowledge of data mining software tools such as SAS, SQL, BO, Cognos or similar
Advanced SAS/SQL programming skills
Demonstrated knowledge of Microsoft Office Applications
Ability to merge multiple databases and data sources to produce answers to complex business questions
Familiarity with coding systems (i.e., CPT, ICD9, ICD10) and hospital billing systems (DRGs)
Demonstrates intellectual curiosity, takes initiative and focuses on continuous improvement
Ability to learn quickly and multi-task in a fast-paced, work environment
Ability to communicate verbally and in writing in English in a clear, professional manner
Ability to travel between locations
Master’s degree in a public policy, public administration, economics, health care administration, epidemiology, statistics, or a related field
Previous work experience managing or mentoring junior analysts

Healthcare Data Analyst Resume Examples & Samples

Assist in the reporting of complex health care issues, including reporting of both health care utilization and unit cost metrics, complex financial reporting and development of advanced analytic outputs
Develop reports and analyze data to measure clinical outcomes, network performance and methodology levers
Develop medical cost reporting, including standardization of cost categories of service, unit cost and utilization metrics
Assist in development of business requirements for decision support tools and reports
Create dashboards generated from claims, prior authorization, and lab data to support departmental functions
Receive, interpret and complete data requests from leadership and stakeholders
Large Healthcare Data Analytics
Collaborates with internal and external partners to understand data needs and design analytic studies that provide actionable results
Supports Medical and Financial programs through reporting and tracking of initiatives
Proactively identifies potential areas for medical cost improvements and alternative pricing strategies
Maintains and distributes monthly reports to members of the senior leadership team including refreshing of standard reports as well as designing and providing ad hoc reports upon request
Manages change to requirements through effective use of change control processes and tools
At least two (2) years working with data, reporting, and analysis in a workplace setting
At least two (2) years working in a healthcare or managed care environment preferred

Technical Healthcare Data Analyst Resume Examples & Samples

Gathering and integrating data from various sources
Building models and analyzing data to unearth trends and patterns
Supporting system testing, user acceptance testing and coordination of implementation activities
Leading discussions with State, providing advice, and helping make critical business decisions
Ensuring that system documentation is updated according to State standards
Providing status reporting
Understanding of Medicaid data
Experience with running SQL queries and reporting
Heavy Technical Aptitude required

Senior Healthcare Data Analyst Resume Examples & Samples

Develop Analysis to historically trend and monitor payer process and payment level behaviors
Develop strategies to minimize payer reimbursement delays and maintain or elevate payment levels
Develop executive level reports to summarily demonstrate financial impact of payment level shifts and process impact from informal and formal payer adjudication process shifts
Provide support and input to Air Methods’ legal department and executive leadership to assist in payer contract negotiation
Financial planning and analysis related to revenue and payer contracts
Assist with annual revenue and department budget process
Assist functional leaders and other areas of the business in reporting and analysis of results
Partner with the operations and leadership team as financial leader for strategy and growth
Bachelor’s degree (BS/BA) in Finance, Accounting, Healthcare Economics or related area from a four-year college or university; and five (5) to seven (7) years’ related experience and/or training
MBA preferred, or equivalent combination of education and experience
Three years’ experience healthcare analysis
Five years’ experience in revenue cycle operations of a healthcare setting with leadership responsibilities; preferably claims, appeals, coding, and/or cash posting
Previous consulting experience preferred (internal or external)
Advanced understanding of payer mix impact on net revenue
Global understanding of the Affordable Care Act and its impact on the healthcare delivery system
General knowledge of current healthcare issues, particularly pre-hospital services
Experience applying statistical analysis to real world data sets
Demonstrates high critical thinking and reasoning skills and strong attention to detail while working in a fast paced environment that requires ability to prioritize and multi-task
Ability to analyze and/or organize complex information with broad direction. Identifies trends. Actively seeks the input and opinions of stakeholders; explores and compare a wide range of options before acting
Ability to develop and present recommendations from accurate assessments and/or analysis. Offers solutions and designs to solve process, project or program issues. Defends a recommendation and can confidently support it
Ability to tackle ambiguous situations and develop solutions with minimal supervision
Ability to be a team player with a professional attitude
Strong business acumen with the ability to understand business situations, strategies, theory, processes, management, budgeting and operations
Advanced with Microsoft Office Suite, including Word, Outlook, PowerPoint and Excel and the use of pivot tables
Experience in SQL and/or SaaS reporting a plus

Healthcare Data Analyst Resume Examples & Samples

Generate complex datasets from Oracle for external and internal clients
Review incoming clinical data for anomalies and issues
Review and verify the quality and accuracy of other analysts’ deliverables
Collaborate with internal teams and different levels of management
Maintain high standards of data integrity and timeliness
3+ years of experience in healthcare industry
2+ years of SQL experience, preferably in Oracle environment
Experience with clinical/EMR data or systems
Understanding of healthcare industry terminology and coding (e.g. NDC11, ICD9/ ICD10, HCPCS, CPT)
Curiosity and excitement to dig into and understand clinical data
Ability to juggle multiple and changing priorities
Strong communication, analytical and problem solving skills

Senior Healthcare Data Analyst Resume Examples & Samples

Produce reports on the GIC’s historic financial and enrollment trend data
Provide forecasting analyses that can guide recommendations for future benefit modifications
Recommend funding levels and current funding status on basis of enrollment, utilization and health care cost trends including GIC's annual Demographic and Cost Analysis, Out-of-Pocket, High-Cost Claimant, and Municipalities
Work with the Executive Leadership team to research and develop reports, briefing papers and verbal presentations
Use plan reports, GIC claims data warehouse, and other data sources to track health plans' financial performance and identify cost-drivers
Utilize the GIC data warehouse business intelligence tools to further the department’s objectives in oversight and management of its health and welfare plans and contribute to overall GIC strategy
Manage the relationship with agency's data warehouse and business intelligence vendor. Work with the vendor and health plans to ensure timeliness and quality of data exchanges. Oversee procurements of data warehouse and analytic services
Serve as an analytic resource and liaison for internal and external resources; work with health care consultants, data quality agencies, and other vendors. Respond to inquiries and report requests from Fiscal Affairs Division, legislative committees / staff, GIC staff, auditors, and other government agencies including municipalities, as needed. Gather and document business requirements and ensure the accurate interpretation of data outputs
Conduct quantitative analysis and use statistical methods of evaluation, in program and policy assessment
Participate in annual rate renewal/development, working closely with department Director and the Director of Budget and Planning as well as external consultants to assure consistency between rate development and the agency’s likely future costs
Assist the department to monitor health plan compliance with contractual, operational and strategic performance standards. Report results and recommend appropriate responses
Maintain knowledge of federal, state and other employers’ policies and programs related to health and welfare plan coverage
Excellent knowledge and experience with healthcare analytics within finance, accounting and/or budgetary, particularly in the area of health plan spending
Strong, proven analytics capacity, along with the ability to assist with budget forecasting / justification within the context of fiscal policy development
Proven experience developing and manipulating reports and spreadsheets using Excel, Access, and business intelligence tools to access large-volume relationship medical claims databases and develop ad hoc reports
Must have knowledge of statistical methods and procedures used in the insurance field and a working understanding about how data warehouses are structured
Strong written and oral communication skills and an ability to work across department/divisional lines and to interact comfortably with personnel at various levels of responsibility is required
Working knowledge of the principles and practices of health and welfare plans, public
Personnel administration, health care cost containment and employee benefits is desired
Experience working within a public/government entity and a health insurer with coverage to large clients and exposure to legislative statutory language as relates to fiscal/budgetary policy within the government sector, a plus
Master’s degree preferred or a Bachelor’s degree with commensurate experience
Ability to meet deadlines and work independently
Familiarity with project management methodologies desired
Must thrive in a strategically dynamic environment

Healthcare Data Analyst Resume Examples & Samples

Assist in the financial reporting, budgeting and forecasting process
Research, collect, manipulate, interpret and verify data
Prepare and distribute analytical data reports and/or records
Respond to inquiries made regarding analysis and reports
Work with the defined scope of various ongoing projects

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