Data Analyst

WellSky Corporation; United States; On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Mental Health support

Paid time off + 13 holidays

100% vested 401(k) retirement plan

Educational assistance

Job summary

WellSky Corporation is seeking a Data Analyst for Value-Based Insights (VBI) to transform Medicare CMS claims data into actionable metrics for Home Health and Hospice providers and payers. You will build and maintain claims-based extracts, translate CMS methodologies into production SQL, and partner with product and engineering to deliver data-driven insights.

The role requires 2–4 years of data analysis experience with strong SQL skills against large datasets and direct CMS claims data

Qualifications

• Bachelor’s degree in quantitative, health informatics, or related field, or equivalent work experience.
• 2–4 years of experience in data analysis with proficiency in SQL against large datasets.
• Direct experience with Medicare/CMS claims data (e.g., CCW, LDS, LDS/RIF files).
• Comfort with healthcare claims coding structures (ICD, HCPCS/CPT, revenue codes, DRGs).
• Ability to translate specifications into analytical logic and validate results.

Responsibilities

• Build and maintain claims-based data extracts and performance measures from CMS data sources (CCW and LDS).
• Develop measures such as HHVBP, MSPB-PAC, functional items, and utilization metrics.
• Translate CMS methodologies into production SQL logic and optimize SQL against large datasets.
• Produce data extracts and validate against CMS benchmarks and client expectations.
• Prepare data for BI/visualization layers (Sisense) and define technical requirements with PMs and engineers.

Skills

SQL

BigQuery

Python

CMS claims data

Data analysis

Education

Bachelor’s degree in quantitative/health informatics

Tools

BigQuery

Sisense

Tableau

Power BI

Job description

Job Overview

The Data Analyst for Value-Based Insights (VBI) transforms Medicare (CMS) claims data into metrics, benchmarks, and measures that power WellSky's VBI product for Home Health and Hospice providers and payers. The role builds and maintains claims-based data extracts, translates CMS methodologies and regulatory rules into production analytics, and partners with product and engineering to deliver trusted, data-driven insights.

Key Responsibilities

• Build and maintain claims-based data extracts and performance measures from CMS data sources (CCW and LDS) to support VBI Home Health and Hospice solutions.
• Develop and maintain performance measures such as HHVBP claims-based measures, MSPB-PAC, Functional Items, hospitalization/ER/PPH/DTC rates, utilization and efficiency metrics, length of stay, and composite/percentile scores.
• Interpret CMS regulations and annual Final Rules (e.g., HHVBP methodology, eTPS calculations) and translate measure specifications into accurate, reproducible SQL logic.
• Write and optimize SQL against large claims datasets in BigQuery; contribute to data pipelines, quarterly lookup-table refreshes, and extract automation.
• Produce referral pattern, competitive analysis, market/benchmark extracts, and validate outputs against CMS public benchmarks (e.g., Home Health Compare) and client expectations.
• Investigate data quality issues and metric discrepancies, document methodology, data sources, and assumptions to ensure results are auditable and repeatable.
• Prepare data for downstream BI/visualization layers (e.g., Sisense) and collaborate with product managers and engineers to define technical requirements and analytical interpretations.
• Perform other job duties as assigned.

Required Qualifications

• Bachelor’s degree in quantitative, health informatics, or related field, or equivalent work experience.
• 2–4 years of experience in data analysis with demonstrated proficiency in SQL against large, complex datasets.
• Direct experience working with Medicare/CMS claims data (e.g., CCW, LDS, LDS/RIF files or comparable claims sources).
• Comfort with healthcare claims coding structures (ICD, HCPCS/CPT, revenue codes, DRGs).
• Ability to translate written specifications or methodologies into analytical logic and validate results for accuracy.

Preferred Qualifications

• Knowledge of Home Health and/or Hospice operations, post‑acute care, or value‑based care programs (e.g., HHVBP, HHVBP eTPS, hospice HIS/HOPE).
• Experience with CMS quality/value‑based program methodologies and familiarity with reading CMS regulations/Final Rules.
• Hands‑on experience with BigQuery (or a comparable cloud data warehouse such as Snowflake) and a BI tool such as Sisense, Tableau, or Power BI.
• Familiarity with risk adjustment or benchmarking concepts.
• Scripting experience (e.g., Python) for data transformation and automation.

Job Expectations

• Willingness to work additional or irregular hours as needed, particularly around quarterly CMS data refreshes and annual Final Rule cycles.
• Compliance with applicable security and HIPAA policies to safeguard company and client protected health information.
• Flexibility to sit and view a computer screen for extended periods of time.

Benefits

• Excellent medical with Rx, dental, and vision benefits.
• Mental Health support through EAP.
• Generous paid time off, plus 13 paid holidays.
• 100% vested 401(k) retirement plan.
• Educational assistance up to $2,500 per year.

Equal Employment Opportunity Statement

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug‑free workplace. Applicants for U.S.‑based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client‑facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.