Senior Data Analyst

Summary

Join our team as a Senior Data Analyst specializing in healthcare claims, payer analytics, and reimbursement models. You will be instrumental in analyzing medical and pharmacy claims data to inform contract negotiations, provider reimbursement strategies, and sales efforts. Your expertise in payer systems, Medicare reimbursement, and healthcare financial models will be crucial. You will develop financial models, collaborate with various teams, and build data visualizations. This role requires a strong analytical background and proficiency in data analysis tools. The ideal candidate will possess excellent communication skills to effectively present data-driven insights.

Requirements

• Bachelor’s or Master’s degree in Healthcare Analytics, Statistics, Finance, Data Science, or a related field
• 3+ years of experience in healthcare claims analysis, payer analytics, or reimbursement modeling
• Strong knowledge of Medicare and commercial payer reimbursement methodologies
• Experience with medical and pharmacy claims data, provider fee schedules, and healthcare financial modeling
• Proficiency in SQL, Python, R for data analysis
• Excellent communication skills to present data-driven insights to stakeholders

Responsibilities

• Analyze medical and pharmacy claims data to identify trends, cost drivers, and opportunities for optimization
• Support provider contracting and payer negotiations by evaluating reimbursement models, pricing structures, and fee schedules
• Develop financial models to assess payer performance, reimbursement strategies, and cost containment opportunities
• Collaborate with sales and contracting teams to provide data-driven insights that support growth initiatives
• Work with Medicare, Medicaid, and commercial claims data to track reimbursement trends and regulatory changes
• Build reports and dashboards using SQL, Python, Power BI, or Tableau to visualize key business metrics
• Evaluate the financial impact of alternative payment models, value-based care initiatives, and provider incentives
• Ensure data integrity and accuracy in claims analysis to support strategic decision-making
• Partner with internal teams to streamline claims processing, payment accuracy, and operational efficiencies

Preferred Qualifications

Familiarity with contract negotiations, network management, and provider relations is a plus