Hybrid Data Insights Researcher – Program Integrity

Delta Dental Plan of Michigan, Inc.; Okemos (MI); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Short- and long-term disability

Life insurance

401(k) savings plans

Flexible spending accounts

Tuition reimbursement or educationally

Annual incentive compensation

Eight hours of paid volunteer time

On-staff health coach and personal gym

Many other perks

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a Professional Review Data Researcher in Okemos, MI. The role focuses on transforming raw data into actionable information to support program integrity and clinical outcomes, with a hybrid work arrangement.

You will design analytics, develop dashboards, investigate referrals, and communicate insights to internal stakeholders. A bachelor's degree and 3 years of data analytics experience in a business setting are required, along with strong

Qualifications

• Bachelor's degree in a related field with 3 years of data analytics experience.
• Knowledge of insurance business, claims processing and business applications.
• Experience with data extraction and analysis tools (Excel, Access, PowerPoint, Oracle Discoverer, ACL).
• Strong communication skills and the ability to use independent judgment.

Responsibilities

• Designs, develops, validates, and deploys data-driven analytics, models, reporting solutions, and end-to-end research.
• Investigates referrals, performs provider research, analyzes billing and treatment patterns to identify anomalies.
• Develops recommendations regarding provider placement on Focused Review and related communications.
• Creates dashboards, databases, monitoring reports, scripts, and automated workflows.
• Transforms and cleanses data to ensure analysis-ready information and data integrity.
• Tracks denial trends, overpayments, and provider performance metrics for program integrity.

Skills

Data analytics

Communication skills

Independent judgment

Education

Bachelor's degree in computer science, information systems, business administration or related field

Tools

Microsoft Excel

Access

PowerPoint

Oracle Discoverer

ACL

Job description

Delta Dental of Michigan, Ohio, and Indiana is seeking a Professional Review Data Researcher in Okemos, MI. The role focuses on transforming raw data into actionable information to support program integrity and clinical outcomes, with a hybrid work arrangement.

You will design analytics, develop dashboards, investigate referrals, and communicate insights to internal stakeholders. A bachelor's degree and 3 years of data analytics experience in a business setting are required, along with strong