Sr Data Analyst, Healthcare Claims Audit and Compliance (Hybrid NY)

Healthfirst; Layton (UT); On-site; USD 83,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage.

401(k) contributions

Life insurance

Job summary

Healthfirst seeks a Senior Analyst, Audit and Compliance Analytics to leverage healthcare data, analytics tools, and business knowledge to support Internal Audit, Compliance Analytics, and Claims Configuration Audit initiatives. You will partner with cross-functional teams to identify risks, evaluate controls, and develop reporting that drives operational excellence and payment accuracy.

The role involves creating dashboards and advanced queries, validating data, and communicating findings to

Qualifications

• Bachelor’s degree or equivalent work experience.
• 3+ years of equivalent experience.
• Proficiency in scripting and programming.
• Experience using MS Office suite including Access, Excel, and Word.
• Expertise in data analysis and query tools such as SQL.
• Experience with Alteryx, Tableau, Redshift, or similar tools.
• Applied statistics skills (distributions, testing, regression).
• Ability to run queries from a data warehouse.
• Experience innovating and implementing audit techniques.
• Excellent communication skills.

Responsibilities

• Analyze complex healthcare datasets to identify trends, anomalies, control gaps, and potential compliance or operational risks.
• Support Internal Audit, Compliance, and Claims Configuration Audit activities through data analysis, audit testing, monitoring, and reporting.
• Develop advanced SQL, SAS, or other analytical queries to extract, validate, and analyze data from multiple sources.
• Evaluate data quality and standardize data structures to support reporting and analysis.
• Create and maintain dashboards, scorecards, reports, and monitoring tools for leadership and stakeholders.
• Summarize findings, methodologies, and recommendations for technical and non-technical audiences.
• Assist in validation of claims configuration changes, business rules, and controls.
• Document analytical processes, data issues, methodologies, and business requirements.
• Collaborate with Internal Audit, Compliance, Claims Operations, Configuration, IT, and other partners.
• Demonstrate curiosity and identify opportunities for process and reporting improvements.

Skills

Scripting & programming

MS Office (Access, Excel, Word)

SQL

Alteryx

Tableau

Redshift

Applied statistics

Audit techniques

Education

Bachelor's degree

3+ years experience

Tools

Alteryx

Tableau

Amazon Redshift

Job description

The Senior Analyst, Audit and Compliance Analytics leverages healthcare data, analytical tools, and business knowledge to support Internal Audit, Compliance Analytics, and Claims Configuration Audit initiatives. This role partners with cross‑functional teams to identify risks, evaluate controls, analyze claims and configuration data, and develop reporting that supports operational excellence, compliance, and payment accuracy. The individual will work on strategic initiatives with visibility across the organization and contribute to data‑driven decision making.

Responsibilities

• Analyze complex healthcare datasets to identify trends, anomalies, control gaps, and potential compliance or operational risks.
• Support Internal Audit, Compliance, and Claims Configuration Audit activities through data analysis, audit testing, monitoring, and reporting.
• Develop advanced SQL, SAS, or other analytical queries to extract, validate, and analyze data from multiple sources.
• Evaluate data quality and standardize data structures to support consistent reporting and analysis.
• Create and maintain dashboards, scorecards, reports, and monitoring tools that provide actionable insights to leadership and business stakeholders.
• Summarize findings, methodologies, and recommendations for technical and non‑technical audiences.
• Assist in the validation of claims configuration changes, business rules, and operational controls.
• Document analytical processes, data issues, methodologies, and business requirements.
• Collaborate with Internal Audit, Compliance, Claims Operations, Configuration, IT, and other business partners.
• Demonstrate intellectual curiosity and identify opportunities for process, control, and reporting improvements.
• Perform additional duties as assigned.

Minimum Qualifications

• Bachelor’s degree from an accredited institution or equivalent work experience.
• 3+ years of equivalent experience.
• Proficiency in scripting and programming skills.
• Experience using MS Office suite, including Microsoft Access, Excel, and Word.
• Expertise in utilizing data analysis and query tools such as SQL.
• Experience with Alteryx, Tableau, Amazon Redshift, or other similar tools/platforms.
• Experience with applied statistics skills, such as distributions, statistical testing, regression, etc.
• Ability to successfully run queries from a data warehouse.
• Experience innovating and implementing audit techniques.
• Excellent communication skills.
• Excellent time management and the ability to prioritize work and complete assignments within their allotted deadline.
• Experience working with and communicating technical information to multiple levels of technical and non‑technical staff in written and verbal form.
• Experience prioritizing a heavy workload in a fast‑paced environment.

Preferred Qualifications

• Master’s degree from an accredited institution.
• Degree in Mathematics, Computer Science, Data Sciences, Engineering, Business Analytics, Informatics, or similar concentration.
• Experience with analytical programming techniques such as Python and R.
• Experience with AWS and analytical solutions available on the platform (Redshift, Glue, SageMaker, etc.).
• Familiarity with programming in JavaScript, D3.js.
• Familiarity with big data technologies, such as Hadoop, MapReduce, and AWS Kinesis.
• Demonstrated ability to develop innovative solutions to complex problems, leveraging advanced problem‑solving skills and sound judgment to make critical, independent decisions within area of responsibility.
• Knowledge of modern machine learning algorithms (clustering, classification and regression), statistical methods and optimization.
• Knowledge of health care industry, systems, business strategies and products.

EEO Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [e-mail] or calling 212‑519‑1798. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying.

Compensation and Benefits

Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $83,100 - $120,360
All Other Locations (within approved locations): $73,400 - $109,225

• Medical, dental, and vision coverage.
• Incentive and recognition programs.
• Life insurance.
• 401(k) contributions.

Benefits are subject to eligibility requirements.