Senior Clinical Data Analyst - 236054

Job Title: Senior Clinical Data Analyst Location: in the Wheeling, WV office, 3x week (NOT REMOTE) Salary: 58,000-68,000 (DOE) Must Have:

Bachelors Degree or higher with a focus on Clinical/BH/Healthcare, Econ, or Statistics Experience working within Excel, data collection and visualization methods. Must be a very analytical work Role: Will be working with all of the clinical services teams because they are going to be a part of the Medical Economics and Program Evaluation.

POSITION SUMMARY: Senior Clinical Data Analyst position will be responsible for analyzing healthcare data of the population from multiple sources (e.g. claims processing, clinical operations, analytical software and other database resources) to support decision-making for The Health Plan. QUALIFICATIONS DESIRED: (Education, Experience, Skills) 1.

Previous work in a medical, managed care, payer, or data driven organization(s). 2. Proficiency in analytical tools such as Excel, SQL, and Power BI. 3. In depth knowledge of healthcare reimbursement elements including medical claims, provider, quality, and pharmacy data. 4.

Familiarity with value-based care, population health management, or HEDIS/STARS quality data. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: • Utilize databases, analytical software programs, and reporting tools to extract data. • Generate reports and perform moderate to complex data analysis to identify trends within a population for potential system/process improvement. • Analyze payer data including claims, eligibility, authorization and utilization data to identify trends, inefficiencies/opportunities within the Clinical Services department as part of the Medical Economics team. • Develop reports and dashboards to track payer performance metrics such as cost, quality, and utilization. • Monitor changes in healthcare regulations and payer policies, assessing their potential impacts on business strategies • Interfacing with, gathering information from, and preparing data for presentations to various levels of management, committees, internal and external. • Supports reporting requirements as needed for governmental and accreditation processes.