Job Description

Our Healthcare Insurance client is seeking a Principal Level Health Insurance Data Analyst to join their team for a contract role!

Our client has over 5,000 employees and is the number 1 health insurer in the state of North Carolina, serving more than 3.89 million customers. Health care is changing, and our client is leading the way by providing innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. Our client is a not-for-profit with headquarters in Durham, NC.

Position: Principal Level Health Insurance Data Analyst
Term: 9 + Months
Location: **Position is Remote, work from home but you must reside in North Carolina or one of the following states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming

Required Skills

• Experience: 5 to 7 years
• Extensive experience analyzing and developing Healthcare data sets.
• Intermediate/Expert proficiency experience with SQL querying/DB development is a must.
• Candidate should have significant experience working with and have business knowledge around the following types of healthcare data sets:

-Medical and Rx Claims -Experience with medical/drug Rebate data is nice to have.

-Provider - Experience with provider Attribution and settlement is a nice to have
-Customer/group data (different business segments/plans
-Risk adjustment /Risk scores
-Medicare and commercial data -

Experience with FACETS (understanding the backend tables/data) is a plus.

Desired Skills

• Strong ability to troubleshoot existing data gaps/deficits and provide solutions is preferred

Description/Comment:

• Leads in the preparation and co-development of complex trend and/or financial analyses for Plan divisions.
• Perform appropriate analysis and logic implementation to ensure the quality and accuracy of data/applications delivered
• Lead and coordinate work related to the identification of business requirements and solutions to support business areas for implementation of accurate financial data.
• Serve as the lead for multiple application areas, including data definitions, usage and file structure, technical structure of the code and the business rules, and structure of requirements that governs the functionality of the system.
• Establishes vendor and interdepartmental relationships to ensure the accuracy and completeness of financial data.
• Take the lead as project manager for the development or enhancement of decision support applications, analyzing, reporting and interpreting data.
• Develops complex decision support applications, data extracts, files, reports, data marts, and/or analysis. Responsible for entire development life cycle.
• Leads in automating applications, extracts, reports, or analysis by providing input to the business requirements and functional specifications (or use cases), reviewing technical specs(to make sure all business requirements are met), participating in the user acceptance testing process, and attend all meetings required to support the project effort.
• Provide analytical support for departmental, divisional and corporate projects as needed to accomplish their business goals and to ensure the business needs are met.
• Performs logic changes, user security management, and application data refreshes.
• Manages the Maintenance and optimization of the Actuarial Systems Data Marts.
• Ensures Financial granular detail data is appropriately auditable, snapshotted and stored for quarterly and year end audits.
• Provides data content support and ensures all data issues are understood and proactively resolved (when possible).
• Keeps abreast of changes in the company and with our external vendor data that affect the departmental processes & systems in order to make recommendations of actions needed And implement changes to the applicable Actuarial Systems data marts and processes where needed..
• Identify complex data problems and issues and is responsible for resolution.
• Provide technical leadership and application expertise to multiple business project teams and non project related activities and in discovery and fact finding for the full understanding and execution of all types of assignments.
• Plan and serve as a key liaison with business areas during development and implementation.
• Identify best practices, communicate and implement these practices within the department.
• Independently analyze business problems or opportunities; develop recommendations and solutions for those problems/opportunities, implement those solutions, and provide communications on the associated actions, business impacts, and results. Facilitate completion of projects within the allocated time and budget
• Coordinate work and provide direction, assistance and training to peers and junior staff members
• Provide detailed configuration expertise to customers and business partners. This includes verbal, written, and electronic communication, and delivering presentations when needed.
• Provide consultative support in analyzing business requirements / use cases / functional requirements in order to ensure the development of efficient enterprise solutions.
• Review Vendors technical design documents to ensure compliance with business area needs and standards.
• Monitor configuration implementations to ensure common standards are followed, makes recommendations for standards improvements.

****To be eligible to contract at this client you must be able to pass a drug test and criminal background check.

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