Overview
Skills
Job Details
Role Overview
We are seeking a highly analytical and detail-oriented Data Analyst with strong SQL expertise and domain experience in healthcare claims, member, and provider data. The role involves analyzing large datasets from multiple healthcare systems, generating insights for business and clinical teams, and ensuring the accuracy and completeness of claims and member-level reporting.
Key Responsibilities
1. Data Management & Analysis - Extract, clean, and transform large volumes of healthcare data (claims, member, provider, encounter, eligibility). - Develop and optimize complex SQL queries for data extraction, transformation, and validation. - Analyze claims and eligibility data to identify patterns, trends, anomalies, and cost drivers. - Collaborate with business stakeholders to understand reporting needs and deliver actionable insights.
2. Reporting & Visualization - Design and maintain dashboards and performance metrics using tools such as Power BI, Tableau, or Looker. - Automate recurring data analysis and reporting tasks. - Develop and maintain standard and ad-hoc reports for claims utilization, member engagement, and provider performance.
3. Data Quality & Validation - Conduct data validation, reconciliation, and quality checks between source systems and data warehouses. - Ensure integrity and accuracy of healthcare data according to CMS, HIPAA, and payer guidelines.
4. Cross-functional Collaboration - Work closely with data engineers, BI developers, and healthcare SMEs to improve data flow and reporting accuracy. - Support actuarial, clinical, and operations teams with custom data extracts and analytical insights.
Required Skills & Qualifications
Bachelor s degree in Computer Science, Data Analytics, Statistics, Healthcare Informatics, or related field.
Data Analyst Healthcare Domain
3 7 years of experience in data analytics within the healthcare domain (payer, provider, or health tech).
Strong SQL proficiency (joins, subqueries, CTEs, window functions, stored procedures).
Experience with healthcare data models (e.g., claims, member, provider, eligibility, encounters).
Understanding of HIPAA, ICD, CPT, and HCPCS codes.
Proficiency with Power BI, Tableau, or Looker for visualization and dashboarding.
Experience working with relational databases (SQL Server, Oracle, Snowflake, BigQuery, etc.).
Strong analytical, problem-solving, and communication skills.
Preferred Skills
Exposure to ETL tools (e.g., Informatica, Talend, Azure Data Factory).
Knowledge of Python or R for data manipulation.
Familiarity with HL7 / FHIR data formats.
Prior experience working in claims adjudication or provider network analytics.