Encounters Data & Claims Insights Analyst II

CareSource; United States; On-site; USD 60,000 - 100,000; Full time

Job summary

CareSource is seeking an Encounters Systems Analyst II to analyze Encounter data and assess financial and clinical impacts of changes on business processes to ensure SLAs are achieved. The role supports regulatory data projects and collaborates with CMS, State agencies, IT, Claims, New Business, and Enrollment teams to address data issues and drive improvements.

The position requires 1–2 years in a managed healthcare environment and proficiency with SQL, SAS, SSIS, MySQL, Oracle, R, or Power BI.

Qualifications

• Bachelor’s degree in Science/Arts or equivalent required.
• Master’s Degree in Science/Arts preferred; concentration in Healthcare Analytics or Data Science preferred.
• Minimum 1–2 years of managed healthcare, claims, or managed care regulated environment experience required.
• Experience using SQL, SAS, SSIS, MySQL, Oracle, R, or PowerBI on data analytics tasks.

Responsibilities

• Analyze Encounter data and assess financial/clinical impact to meet SLAs.
• Review Encounter rejections and resolve data issues or process changes.
• Support regulatory data projects for CMS and State agencies.
• Collaborate with IT, Claims, Enrollment, and other internal teams to improve data quality and adherence to regulations.
• Contribute to documentation of business requirements and user stories for sprints.

Skills

Advanced Excel

Data analysis

Communication skills

Time management

Critical thinking

Education

Bachelor’s degree in Science/Arts or equivalent

Master’s Degree preferred; Healthcare Analytics or Data Science preferred

Tools

SQL

SAS

SSIS

MySQL

Oracle

R

PowerBI

Edifecs

Job description

CareSource is seeking an Encounters Systems Analyst II to analyze Encounter data and assess financial and clinical impacts of changes on business processes to ensure SLAs are achieved. The role supports regulatory data projects and collaborates with CMS, State agencies, IT, Claims, New Business, and Enrollment teams to address data issues and drive improvements.

The position requires 1–2 years in a managed healthcare environment and proficiency with SQL, SAS, SSIS, MySQL, Oracle, R, or Power BI.