Remote Senior Claims Ops & Data Analyst

Health Plan of San Joaquin/Mountain Valley Health Plan; French Camp (CA); Remote; USD 120,000 - 150,000; Full time

Benefits offered by this job

Remote work contingent on business & G

Tuition reimbursement

Health coverage options

Paid time off

Retirement plan

EAP

FSAs for healthcare

Annual wellness program

Job summary

Health Plan of San Joaquin is seeking a Senior Claims Operations & Data Analyst to lead advanced data analysis, workflow redesign, and system logic improvements for claims processing. The role blends responsibilities of data and business analysis with a focus on operational scalability and cross-functional impact.

The position supports executive-level diagnostics and performance dashboards, requires strong SQL, Excel, and BI tool skills, and offers remote work within California, with preference

Qualifications

• Bachelor’s degree required.
• Five years of progressively responsible healthcare claims/BA work.
• At least three years SQL-based analysis.

Responsibilities

• Perform advanced SQL queries to analyze claims data and identify trends.
• Redesign workflows, routing logic, and system rules to improve accuracy and efficiency.
• Prepare operational diagnostics and executive-ready materials for leadership.

Skills

Claims operations

SQL

Excel

Visio/Lucidchart

Analytical thinking

Communication

BI tools

Education

Bachelor’s Degree in Healthcare/Related Field

Tools

QNXT

Jiva

Power BI

Tableau

Job description

Health Plan of San Joaquin is seeking a Senior Claims Operations & Data Analyst to lead advanced data analysis, workflow redesign, and system logic improvements for claims processing. The role blends responsibilities of data and business analysis with a focus on operational scalability and cross-functional impact.

The position supports executive-level diagnostics and performance dashboards, requires strong SQL, Excel, and BI tool skills, and offers remote work within California, with preference