Point32Health is currently seeking highly motivated individuals to join their Provider Reimbursement analytics team in the role of Senior Data Analyst. A key role in the Corporate Data and Analytics organization, the Senior Data Analyst is a strategic consultant who can 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
- Design and generate detailed analytics that focus on medical cost, reimbursement trends, and market position 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/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
- Establish strong business relationships, and be regarded as a subject matter expert
- Interface with stakeholders collaboratively, serving as a strategic business partner
Qualifications – what you need to perform the job
Education, Certification and Licensure:
- Bachelor’s degree in Healthcare Finance, Business, Economics, or similar analytical field
- Masters degree preferred
Experience:
- 5-7 years’ related experience in a payer/provider role, with health insurance claims data experience
- Demonstrated experience with complex data exploration, such as aggregation, normalization, validation
- Experience with Agile and Waterfall development methodologies
Skill Requirements:
- 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
- Advanced 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
- Ability to manage multiple tasks independently, take ownership of responsibilities, and meet deadlines
- Comfort with navigating complexity and ambiguity, while maintaining a positive and collaborative spirit
- Strong written and oral communication skills
Commitment to Diversity, Equity & Inclusion
Point32Health is committed to making diversity, equity, and inclusion part of everything we do—from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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.
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: R8023
