Job DescriptionExecute and complete specific deliverables and activities that analyze, validate, and standardize the data-gathering process as well as report statistical data & performance metrics from multiple sources (e.g. insurance processing, performance metrics, clinical operations, demographics, costing reports) in order to fulfill our business and customers' needs.
Healthcare Data Analysis- Design data models that integrate patient data from multiple sources to create complete views of health data.
- Analyze members' health risk segmentation and chronic cases profiling (e.g., chronic disease, cancer, hepatic disease, renal failure).
- Investigate data to find patterns and trends.
Performance Analysis and Reporting- Pull and integrate data from multiple sources.
- Analyze data to assist in delivering optimal healthcare management and decision making.
- Publish monthly reports for mega accounts including different dimensions.
- Develop reports and presentations.
- Ensure accurate and timely completion of daily and monthly reports of all performance metrics.
- Communicate analytical insights with management.
Data Cleansing- Apply advanced categorization of services with standardized and concise mapping.
- Ensure proper validation of doctor names in the data, specialties, modifying and validating of the unified service coding process.
Analysis and Reporting Transformation Initiatives- Collaborate with the different business units and functions in order to execute the assigned objectives related to big data projects and digital enhancements, transformations, and implementations.
- Interpret and validate data to be incorporated into advanced analytics and ML models.
- Automate the manual reports through Power BI.
Skills- Intermediate to advanced skill level with MS Excel, PowerPoint, and Power BI.
- Data Analysis including healthcare claims data manipulation.
- Ability to interpret both high level and detailed view of the data.
- Excellent analytical and communication skills.
EducationMBBS (Bachelor of Medicine & Surgery) with some expertise in Insurance is preferred.