Coverage Enhancements and Appeals Senior Data Analyst - Hybrid

GENERAL SUMMARY OF POSITION:

Under the general direction of the Director or designee, the Sr. Healthcare Data Analyst needs to be insightful, detail-oriented professional with excellent analytical skills who is able to apply that skill set to data analysis, data mining and data management within a medically-oriented, dynamic analytic team.

MAJOR RESPONSIBILITIES:

Conduct advanced data mining as required by the program.
• Lead analyses and produce standard reports using healthcare claims data which support the development, implementation, and monitoring of MassHealth programs.
• Manipulate and build large datasets from claims and encounter data to support analyses through use of efficient SAS/SQL code.
• Utilize strong analytic consulting skills, and a customer service focus in order to design and deliver analytic projects to client specifications.
• Assist 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 trends.
• Merge multiple databases and data sources to produce answers to complex business questions.
• Demonstrate attention to detail and deliver quality work products.
• Other responsibilities and projects as assigned.

REQUIRED QUALIFICATIONS:

• 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

PREFERRED QUALIFICATIONS:

• Master's degree in a public policy, public administration, economics, health care administration, epidemiology, statistics, or a related field.
• Strong critical thinking skills.
• Previous work experience managing or mentoring junior analysts.