Sr. Healthcare Informatics Analyst (Medicare Advantage)
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Overview
Job Description
Job Title: Sr. Healthcare Informatics Analyst (Medicare Advantage)Location: 100% Remote (candidate must reside in an approved state: AL, AR, DE, FL, GA, ID, IN, IA, KS, KY, MS, MO, NH, NE, NC, OK, SC, SD, TN, TX, UT, VA, WV, WI)
Company Overview Glint Tech Solutions is a women-owned, global IT staffing and recruiting firm serving enterprise clients across the USA and Canada.
Project Description A leading healthcare payer client is seeking a Senior Healthcare Informatics Analyst who will independently provide analytics to understand and improve how healthcare is valued, utilized, and provided. This role develops analytic attributes related to patient-level health utilization/outcomes, provider performance measures, risk-adjusted revenue optimization, medical cost management, and patient/provider engagement behavior, collaborating with business areas and IT to lead problem solving, solution development, and strategic planning.
Key Responsibilities
- Independently provide analytics to understand and improve how healthcare is valued, utilized, and provided
- Develop analytic attributes pertaining to patient-level health utilization/outcomes, provider performance measures, and risk-adjusted revenue optimization
- Support medical cost management and analysis of patient/provider engagement behavior attributes
- Lead problem solving, solution development, and strategic planning in collaboration with other business areas and IT
- Ensure compliance with all laws and regulations associated with duties and responsibilities
Mandatory Skills
- Healthcare experience required, with Medicare Advantage trend analysis experience
- Bachelor's degree in healthcare administration, statistics, economics, analytics, or computer science (4 years of relevant experience may substitute; Master's preferred)
- 4+ years of healthcare, analytics, IT, or management consulting experience
- Strong critical thinking, analytical, and problem-solving skills
- Experience building predictive models
- Strong knowledge of SQL, SAS, R, Python, Tableau, or similar query/analytic/visualization tools
- Basic knowledge of the U.S. healthcare delivery system in a payer or provider setting
Nice-to-Have Skills
- Strong knowledge of outcome research design and controlled study design
- Advanced knowledge of SAS, including Enterprise Miner
- Strong understanding of provider payment methodologies, population health management, and risk adjustment
- Strong understanding of clinical groupers, including episode and risk groupers (DRG, APC, ETG, MEG, DxCG, HCC)
- Strong understanding of quality metrics (HEDIS, AHRQ)
- Knowledge of commercial risk optimization and MA risk optimization
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