Data Analyst

Job Summary

Point32Health is currently seeking motivated individuals to join their Provider Reimbursement analytics team in the role of Data Analyst. A key role in the Corporate Data and Analytics organization, the Data Analyst will use analytic tools and processes to deliver meaningful insight on business performance. This role uses claims data and other supporting information to evaluate provider-specific reimbursements for rational and efficient methodology. Your expertise directly impacts financial stability, compliance, and operational capability.

Key Responsibilities/Duties what you will be doing

Generate detailed analytics that focus on medical cost, reimbursement trends, and market position from a provider perspective across business lines and products (Commercial, Medicare, Medicaid, Exchange)

• Utilize extensive knowledge of managed care financing and in-depth understanding of reimbursement methodologies (DRG, PAF, fee schedule, pmpm, value-based payments) in order to develop meaningful assessment of financial performance
• Independently develop SAS and/or SQL queries, Excel pivot tables, and other analytic tools to explore and summarize results
• Produce regulatory submissions for the evaluation of provider cost trends
• Conduct other analyses as needed to support the identification of gaps, variation, and other key performance indicators of reimbursement trends
• Demonstrate problem solving aptitude through critique of analytic methodologies and studies
• Demonstrate strong business problem comprehension, by developing analytic use cases (Who? What? Why?) that accurately capture business needs
• Apply a high level of QA rigor, proactively leveraging peer review and external validation sources
• Develop documentation and methodologies for analyses and deliverables
• Meets assigned timelines and escalates risks/barriers as needed

• Establish strong business relationships, and interface with stakeholders collaboratively

Qualifications what you need to perform the job

Qualifications

• Bachelor's degree in an analytics-related field ( Healthcare Finance, Business, Economics, or similar); Masters degree preferred

• 3-5 years of experience, preferably in a payer/provider setting

Skills

• Moderate to complex analytics experience required, such as aggregation, normalization, and validation

• Intermediate programming skills (e.g., SAS, SQL) required

• Experience with health insurance claims data preferred

• Passion for data and problem-solving

• Aptitude for both the forest and the trees ; able to simplify complex scenarios into key takeaways with compelling data storytelling, as well as drill down into the details behind the summary

• Proficiency with SAS and/or SQL programming, such as: creating new queries, extracting large data sets, and performing data manipulation and analysis. A broad understanding of relational databases and large data structures is key

• Advanced Excel skills such as manipulation of large data sets; creating standardized reports; utilizing functions such as VLOOKUP, formulas, filters, and formatting; creating and interpreting pivot tables

• Demonstrated ability to manage tasks independently, take ownership of responsibilities and meet deadlines

• Strong written and oral communication skills

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Scam alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact [email protected]

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R8324