Data Analyst (Healthcare) (W2 only) – REMOTE

PSS Technology Inc
  • Los Angeles
  • Post Date: January 9, 2025
    • 37654
  • Applications 0
  • Views 0
Job Overview

logoTitle: Data Analyst (Healthcare) (W2 only) Location: Remote (Local to California Required)Duration: ContractInterview Mode : VideoStart Date : Immediate
Job Description:
Education• Master in math, statistics, information systems, computer science, or related field.
Duties:• Report deliveries and identified project milestones being reached• Acclimating to the team, data structures, and existing reporting
Responsibilities• Data Collection and preparationo Extracting data from claims, enrollment, encounter, and payment systemso Cleaning and transforming raw data to ensure accuracy and usabilityo Integrating data from multiple source• Claims and Encounter Analyticso Monitoring encounter data for patterns in operational inefficiencies and risk adjustment valueo Analyzing encounter data to ensure compliance with state and federal guidelineso Measuring provider performance based on metrics like utilization, timeliness, reject rate, and quality of care• Reporting and Visualizationo Building dashboards and reports for leadership and stakeholders using Power BI (e.g. Claims trends, patient outcomes, operational efficiency)o Presenting actionable insights to drive strategy or policy divisiono Ensuring reports align with regulatory requirements• Direct Payment Compliance and Liability Assessmentso Provide reconciliation reporting to stakeholders and payment recipientso Prepare data submissions for regulatory agencies (DHCS)o Ensure encounter and claims data meet reporting deadlines and quality thresholdso Staying updated on policy changes and understanding their impact on programs• Cross-Functional Collaborationo Working with IT to optimize data pipelines and systemso Partnering with Provider Engagement teams to evaluate the effectiveness of reporting• Identifying Opportunities for Improvemento Analyzing member and provider data to identify gaps in care or submission qualityo Recommending operational improvements based on data-driven insightso Testing and validating new analytics tools or methods• Ad Hoc Analysiso Answering data requests from stakeholders within organizationo Investigating anomalies in encounter submissions and escalating or resolving discrepancies• Staying Up to Dateo Keeping current with industry trends, new tools, and best practices in healthcare analyticso Learning about legislative changes that impact health insurance analytics
Software Skills Required: • SQL, Excel, Python
Required Skills/Experience: • Strong SQL Skills• Extract, Transform, Load data from multiple data sources• Data Management• Collaborative, Interpersonal, Oral, And Written Communication• Ability To Work Well With Multiple Internal And External Partners, As Well As Work Independently
Preferred Skills/ Experience: • SAS Enterprise Guide• Teradata, Oracle, Snowflake SQL• PYTHON (DATA WRANGLING & MANAGEMENT)• Ability To Create Technical And Business Process Workflow Diagrams

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