Title: Sr. Data Analyst (Federal Healthcare SME)
Client: CareFirst
Rate Confirmation: $55-$65/hr on W2 or $65-75 on C2C/ C2H - Salary: $157,500K
Work mode: Hybrid - 2-3 monthly visits to the Columbia MD office
Duration: 12 months - CTH
Eligibility: USC
Candidates from Approved States ONLY: DC, MD, VA, PA, DE who can go onsite 2-3 days a month and go for last round onsite interview.
Interview Mode: 2 video rounds - then onsite interview
Top Non-Negotiables (Must Have) - 10+ years of experience as a Data Analyst in healthcare payer domain
- Current Health Insurance Customer Experience
- Strong hands-on experience with CMS Federal Healthcare data, especially CMS Stars program
- Experience with Medicare / Medicaid government healthcare programs
- Deep understanding of Risk Adjustment & Medicare Advantage Quality/Stars programs
- Proven experience working with provider data + claims data integration/analysis
- Experience extracting and working with data from MS Azure
- Hands-on experience with Salesforce (data usage, reporting, or integration)
- Working knowledge of FACETS (healthcare payer system)
- Experience supporting healthcare leadership with analytics-driven decision making
Highly Important (Strongly Preferred) - Building dashboards, reports, and data visualizations
- Handling large-scale healthcare datasets and operational reporting
- Ability to manage multiple priorities and tight deadlines
This position is a contract to permanent opportunity with our customer. Although primarily remote, there will be 2-3 onsite visits per month in their Columbia MD office. We are seeking candidates in one of the follow states to accommodate this onsite request: Wash DC, MD, PA, WV or DE.
We are seeking a Data Analyst who can lead the creation of cutting-edge analytic tools to drive better and faster decision making within our client's healthcare payor organization, and provides critical support for key corporate programs, Medicare Advantage Stars and Risk Adjustment programs as it relates to provider data, provider to claims process.
Must have previous Federal Healthcare/CMS Stars data experience working with leadership on provider data issues, accuracy, and provider data interactions with claims and claims platforms. Knowledge of Salesforce and Facets is required.
ESSENTIAL FUNCTIONS: - 50% Supports enterprise Stars and Risk adjustment strategy through collaboration with analysts, healthcare policy makers, and strategy leaders throughout the company to identify trends and opportunities across the Medicare and Medicaid healthcare landscape. Consults with business leaders, IT partners, and product owners to facilitate product development and guide Stars and Risk Adjustment priorities through insightful analytics.
- 30% Identify and quantify key drivers for the Risk Adjustment and Quality/Stars programs, investigate areas of opportunity, evaluate effectiveness and make recommendations. Apply business knowledge to Analytics projects and provide value-added insights to impact business outcomes, working cooperatively with various internal and external partners. Using the application of sophisticated analytical capabilities, develops and maintains visualizations to support all business divisions across all levels. Develop and maintain scheduled and ad hoc reports for Risk Adjustment and Quality in response to business needs given tight deadlines, minimal direction, and shifting priorities.
- 20% Provide on-going tracking and monitoring of application performance and recommend improvements to methods and algorithms. Work closely with clients, data stewards, and other business and technology leaders to frame problem definition and potential solutions. Required to stay current with Government Programs requirements and directives including those specific to Medicare and Medicaid and update all their reporting and analytics accordingly. Work with external vendors and governmental agencies as required. Excellent organizational skills and ability to set priorities and handle multiple projects concurrently.
Required Skills - Education Level: Bachelor's Degree is required, Masters is preferred. In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
- 10+ years as a Data Analyst, analyzing healthcare payor data to advise senior leadership on how to pivot to ensure data improvement.
- Must have expert knowledge in CMS Federal Healthcare, specifically CMS Stars
- Must have prior expertise extracting data from MS Azure
- Must have prior expertise in SalesForce
- Must have understanding of FACETS
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