Full-Time Forensic Data Analyst, Specialist

• Collaborates with engineers, clinical experts, payment professionals, and business operations leaders.
• Develops reporting and analyzes large-scale healthcare claims and clinical datasets.
• Generates new analytic content ensuring claims are paid accurately.
• Leverages coding, analytic reporting, and predictive modeling to uncover actionable insights.

1. Work cross functionally to identify opportunities for leveraging company data to drive business solutions.
2. Mine and analyze data from healthcare claim databases.
3. Design and develop business intelligence reporting suite for internal and external consumption.
4. Author new analytic content for health plans.
5. Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms.
6. Create predictive modeling to support business reporting and decision making.
7. Coordinate with different functional teams to implement models and monitor outcomes.
8. Develop processes to monitor and analyze model performance and accuracy of results.

• Minimum of 10 years experience manipulating data sets and building statistical models through SQL.
• Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields.
• Experience using enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo).

• Bachelor's degree in business or healthcare/related field (preferred).
• Excellent written and verbal communication skills.
• Experience partnering with Data Science teams, using statistical computer languages (SQL, Python, R).
• Experience working in project management tools (Jira, Confluence).
• Strong problem-solving skills with an emphasis on product development.
• Drive to learn and master new technologies and techniques.
• Experience building and delivering presentations in PowerPoint (or similar).
• Experience across multiple Payment Integrity product areas.

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