Senior Data Analyst, Remote: Risk Adjustment Data Quality

CareFirst, Inc.; Baltimore, Northern (MD, KY); Hybrid; USD 87,000 - 173,000; Full time

Job summary

CareFirst BlueCross BlueShield seeks a Senior Data Analyst to ensure data accuracy and regulatory compliance for Risk Adjustment programs. You will design automated testing, data certification, and reconciliation processes, acting as a subject matter expert across stakeholders and engineering teams.

Responsibilities include leading data validation, root-cause analysis, and production readiness activities while mentoring junior analysts. Strong SQL and cloud data platform experience are required.

Qualifications

• Expert knowledge of healthcare payer data domains including claims, enrollment, provider, diagnosis, procedure, pharmacy, and clinical data.
• Expert knowledge of Risk Adjustment processes and data dependencies.
• Expert ability to design, implement, and maintain automated data testing, certification, and monitoring frameworks.
• Advanced knowledge of data quality principles and regulatory reporting.
• Advanced knowledge of Agile delivery and production readiness.

Responsibilities

• Engage in data exploration using programming languages and various database structures.
• Collect, analyze, and interpret data to develop actionable recommendations.
• Research data flow across complex ecosystems including operational and analytical platforms.
• Serve as a subject matter expert and mentor staff.
• Lead in design, development, validation and delivery of data for business decisions.
• Document technical requirements and audits; coordinate with stakeholders.

Skills

SQL

Data analysis

Root cause analysis

Data testing

Data governance

Education

Bachelor's degree in Data Science, Mathematics, CS, Statistics or related field

Tools

Snowflake

Microsoft Fabric

Azure Data Factory

NoSQL platforms

Job description

CareFirst BlueCross BlueShield seeks a Senior Data Analyst to ensure data accuracy and regulatory compliance for Risk Adjustment programs. You will design automated testing, data certification, and reconciliation processes, acting as a subject matter expert across stakeholders and engineering teams.

Responsibilities include leading data validation, root-cause analysis, and production readiness activities while mentoring junior analysts. Strong SQL and cloud data platform experience are required.