Medicare Claims Analytics Specialist

WellSky Corporation; Overland Park (KS); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

Mental Health Support

Paid time off

401(k)

Educational assistance

Job summary

WellSky is seeking a Data Analyst for the Value-Based Insights (VBI) team in Overland Park to transform CMS Medicare claims data into actionable metrics and benchmarks for Home Health and Hospice clients.

You will build data extracts from CCW and LDS, translate CMS methodologies into production analytics, and partner with product and engineering to deliver auditable, data-driven insights using SQL and BigQuery.

Qualifications

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

Responsibilities

• Build and maintain claims-based data extracts and measures from CMS sources.
• Develop and maintain HHVBP, MSPB-PAC, and utilization metrics.
• Translate CMS methodologies into production SQL logic and optimize queries in BigQuery.
• Support data pipelines and quarterly data refreshes; automate extracts.
• Prepare data for downstream BI/visualization layers and collaborate with PMs/engineers.

Skills

SQL

Medicare CMS claims data

BigQuery

Python

Education

Bachelor's degree in quantitative/health informatics or related field

Tools

Sisense

Tableau

Power BI

Job description

WellSky is seeking a Data Analyst for the Value-Based Insights (VBI) team in Overland Park to transform CMS Medicare claims data into actionable metrics and benchmarks for Home Health and Hospice clients.

You will build data extracts from CCW and LDS, translate CMS methodologies into production analytics, and partner with product and engineering to deliver auditable, data-driven insights using SQL and BigQuery.