Health Care Analyst III

SCAN Health Insurance; Long Beach (CA); À distance; USD 92 000 - 134 000; Plein temps

Avantages offerts par ce poste

Annual bonus program

Wellness program

Generous PTO

11 paid holidays + birthday/floating

401(k) with employer match

Résumé du poste

SCAN Health Insurance is seeking a Healthcare Analyst II to develop, document, and program for 5-Star projects and internal initiatives. You will conduct in-depth data analysis, HEDIS reporting, and related tasks to support high-quality care.

Your work spans Medicare Advantage data across membership, claims, authorizations, pharmacy, and financial information. This role leads QA processes, data management, and cross-functional collaboration to meet tight deadlines.

Qualifications

• Bachelor’s or above degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines.
• 5+ years of analytical experience, or 4+ years in Healthcare/Managed Care analytics.
• Experience with HEDIS and medical claims data is preferred.
• Advanced MS Office and SQL/BI tool experience required.

Responsabilités

• Research and moderate analysis of Medicare Advantage and healthcare data across membership, provider, claims, authorizations, pharmacy, and financial info.
• Design and deliver analyses related to 5-Star ratings, HEDIS, and state program initiatives.
• Lead QA processes to ensure accuracy and reliability of reported data.
• Perform data management, quality improvement studies, and statistical analyses; present to analysts and management.
• Collaborate with internal/external stakeholders to troubleshoot data anomalies and meet deadlines.

Connaissances

Analytical thinking

Interpersonal communication

Written communication

Formation

Bachelor’s or above degree in Math, Statistics, Biostatistics, Computer Science, or quantitative disciplines

Outils

MS SQL

Snowflake

SSRS

SSIS

SAS

Power BI

MS Office

Description du poste

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

Th e Healthcare Analyst II I develops, documents, and programs in support of 5-Star projects and in-house initiatives. In pursuit of high 5-Star ratings, conducts in-depth data analysis and interpretation, HEDIS reporting, and other related tasks.

You Will

• Responsible for research and moderate analysis of Medicare Advantage and healthcare data specific to membership, provider, claims, authorizations, pharmacy, and financial information.
• Designs and produces timely and meaningful analysis and data interpretation regarding large health care related datasets, related to 5-Star ratings, HEDIS, state specific programs (such as QIP/PIP), programs issued by state agencies (such as DHCS or HSAG) and other associated company initiatives.
• Leads in development, implementation, and document quality assurance (QA) processes to ensure that reported data is accurate and reliable.
• Conducts data management, quality improvement studies, statistical analysis, and report generation. Presents findings to higher level Analysts as well as HCI mid and senior management.
• Performs moderate to complex analysis and interprets organizational data, including but not limited to data mining, data verification, mapping, scrubbing, and scrapping.
• Develops and deliver actionable and supportable findings within tight deadlines and changing requirements.
• Conducts investigative research to uncover root causes, interpret results, identify trends, and make recommendations for action.
• Works directly with internal and external stakeholders to troubleshoot and correct data anomalies.
• Manages multiple moderate to complex projects concurrently. Completes them accurately within a specified timeline by effectively prioritizing work and communicating workload issues to manage-ment.
• Leads in training, providing guidance, and supporting lower level Analysts.
• Serve as a point of contact for internal and external customers and resolves both routine and more complex questions and problems. Escalates only the most complex issues to higher levels as needed.
• Ensures understanding of business needs by proactively monitoring and clarifying the technical responses to business requirements on all Medicare related projects.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Your Qualifications

• Bachelor’s or above degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines required.
• 5+ years of analytical experience, or 4+ years of analytical experience in a Healthcare, Managed Care environment required.
• Experience with HEDIS is preferred.
• Experience with medical claims / encounters data is preferred.
• MS Office Suite at advanced level required.
• Proficiency with MS SQL (queries) required.
• Snowflake experience is preferred.
• SQL Server Reporting Services and SQL Server Integration Services experience preferred.
• SAS (Statistical Analysis System) experience preferred.
• Power BI tool experience preferred.
• Excellent technical, interpersonal written and oral communication skills required.

What’s in it for you?

• Base Pay Range: $92,400 to $133,671annually
• Work mode: Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, 1 floating holiday, and 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affinitive Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)