Senior Operations Data Analyst

Ventura County Medi-Cal Managed Care Commission; United States; Remote; USD 100,000 - 150,000; Full time

Job summary

Gold Coast Health Plan in California seeks a senior data analytics professional to perform advanced statistical analysis on healthcare data, develop models, and translate findings into actionable business insights.

You will build dashboards with Power BI, write complex SQL queries, and collaborate across IT and operations to support enterprise analytics and regulatory reporting, including Grievances, Appeals, Encounters, and Risk Adjustment.

Qualifications

• Bachelor’s degree in a quantitative field and strong data analysis experience.
• 5+ years of data analysis, BI, or related analytical work.
• Proficient in SQL and relational databases.
• Experience with Power BI or similar data visualization.
• Ability to apply statistical methods to business problems.
• Equivalent years of experience accepted in lieu of degree.

Responsibilities

• Perform advanced statistical and quantitative analysis of healthcare, operational, claims, encounter, membership, and other enterprise data.
• Develop statistical models and algorithms to identify anomalies, patterns, trends, risks, and opportunities that support operational and strategic decision-making.
• Apply appropriate statistical methodologies including regression, hypothesis testing, forecasting, segmentation, outlier detection, trend analysis, and other quantitative techniques.
• Develop and maintain analytical solutions using SQL, Python, R, Power BI, and other approved analytical tools.
• Serve as the analytical owner or subject matter resource for assigned operational domains.
• Develop enterprise dashboards, reports, data visualizations, and analytical products that translate complex information into actionable business insights.
• Automate recurring analytical processes, regulatory metrics, operational KPIs, and data validation activities.
• Analyze large and complex datasets from multiple sources and identify relationships, trends, data-quality issues, and opportunities for improvement.
• Perform data profiling, validation, reconciliation, and quality analysis to ensure analytical outputs are accurate, complete, and appropriate for their intended use.
• Develop and maintain data models, analytical datasets, data definitions, and source-to-target mapping documentation.
• Partner with business stakeholders to define analytical questions, identify appropriate methodologies, establish measures of success, and translate findings into business recommendations.
• Collaborate with Information Technology, Enterprise Analytics, developers, data engineers, consultants, and other technical resources to improve enterprise data assets and analytical capabilities.
• Support development and enhancement of enterprise data warehouse solutions, including Microsoft Azure Synapse and other approved platforms.
• Develop analytical solutions supporting regulatory and operational functions including Grievances & Appeals, Encounters, Risk Adjustment, Claims, Membership, and related areas.
• Evaluate patterns and anomalies within claims and encounter data that may indicate operational issues, payment variation, data-quality concerns, or opportunities for further investigation.
• Develop methodologies to measure operational performance, identify statistically significant variation, and evaluate the effectiveness of operational interventions.
• Perform exploratory data analysis to identify opportunities for new analytical models, measures, and decision-support tools.
• Clearly document analytical methodologies, assumptions, limitations, data sources, and results.
• Present complex analytical findings to technical and non-technical audiences in a clear and actionable manner.
• Provide analytical guidance and technical support to Data Analyst I staff and other members of the Operations Analytics team as appropriate.
• Participate in cross-functional projects and enterprise initiatives requiring advanced analytical expertise.
• Maintain awareness of emerging analytical techniques and technologies and recommend opportunities to improve the department’s analytical capabilities.
• Ensure analytical solutions meet business requirements, organizational standards, and applicable regulatory requirements.
• Provides subject matter expertise.Perform other duties as assigned.

Skills

Advanced SQL

Relational databases

Power BI

Microsoft Office

Python

R

Data visualization

Education

Bachelor’s degree in Statistics

Bachelor’s degree in Mathematics

Bachelor’s degree in Data Science

Bachelor’s degree in Computer Science

Bachelor’s degree in Economics

Bachelor’s degree in Information Systems

Bachelor’s degree in Business Analytics

Equivalent In lieu of degree

Tools

Advanced SQL/T-SQL

Relational databases

Power BI

Microsoft Azure

Azure Synapse Analytics

Databricks

Git

Job description

Gold Coast Health Plan in California seeks a senior data analytics professional to perform advanced statistical analysis on healthcare data, develop models, and translate findings into actionable business insights.

You will build dashboards with Power BI, write complex SQL queries, and collaborate across IT and operations to support enterprise analytics and regulatory reporting, including Grievances, Appeals, Encounters, and Risk Adjustment.