Note: The job is a remote job and is open to candidates in USA. Brighton Health Plan Solutions is seeking a Senior Data Analyst for Clinical Programs. This role involves analyzing data and processes to identify opportunities for improvement and supporting various clinical initiatives through actionable insights.

Responsibilities

• Monitor Utilization Management and Case Management activities through the development of KPIs and benchmarks (i.e. member engagement rates, readmissions, preventable hospitalizations, ER utilization)
• Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources
• Develop algorithms for stratifying populations and identifying high-risk members
• Leverage Predictive Analytics to measure the performance (ROI) of Disease Management and other Medical Management programs
• Conduct prospective savings analyses in support of clinical program initiatives
• Build and maintain client-facing reports, dashboards, and analyses
• Develop actionable data insights and advise on client strategy
• Participate in program performance review presentations with clinical program managers, client account managers, and external clients, as needed
• Manage internal and external client requests and timelines to ensure timely delivery
• Collaborate with Medical Management to provide ongoing support

Skills

• Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field
• 5-7 years of experience in healthcare analytics, preferably in a managed care setting
• Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required
• Proficiency in MS Excel required
• Advanced data analysis, financial modeling, and predictive analytics skills
• Experience with clinical program evaluation and outcomes reporting
• Experience with health plan performance reporting and cost and utilization analysis
• Experience with developing client-facing reports
• Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau)
• Ability to explain technical concepts to a non-technical audience
• Ability to effectively manage and prioritize several concurrent projects
• Excellent oral and written communications skills
• Experience with Payer Care Management platforms (i.e. ZeOmega) a plus

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