Note: The job is a remote job and is open to candidates in USA. Brighton Health Plan Solutions is seeking a Senior Data Analyst for Clinical Programs. This role involves analyzing data and processes to identify opportunities for improvement and supporting various clinical initiatives through actionable insights.
Responsibilities
- Monitor Utilization Management and Case Management activities through the development of KPIs and benchmarks (i.e. member engagement rates, readmissions, preventable hospitalizations, ER utilization)
- Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources
- Develop algorithms for stratifying populations and identifying high-risk members
- Leverage Predictive Analytics to measure the performance (ROI) of Disease Management and other Medical Management programs
- Conduct prospective savings analyses in support of clinical program initiatives
- Build and maintain client-facing reports, dashboards, and analyses
- Develop actionable data insights and advise on client strategy
- Participate in program performance review presentations with clinical program managers, client account managers, and external clients, as needed
- Manage internal and external client requests and timelines to ensure timely delivery
- Collaborate with Medical Management to provide ongoing support
Skills
- Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field
- 5-7 years of experience in healthcare analytics, preferably in a managed care setting
- Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required
- Proficiency in MS Excel required
- Advanced data analysis, financial modeling, and predictive analytics skills
- Experience with clinical program evaluation and outcomes reporting
- Experience with health plan performance reporting and cost and utilization analysis
- Experience with developing client-facing reports
- Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau)
- Ability to explain technical concepts to a non-technical audience
- Ability to effectively manage and prioritize several concurrent projects
- Excellent oral and written communications skills
- Experience with Payer Care Management platforms (i.e. ZeOmega) a plus
Company Overview
Brighton Health Plan Solutions is a health care company that specializes in health plan management service. It was founded in 2016, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is https://brightonhps.com.