Sr. Data Analyst

E2E Alignment Healthcare USA, LLC; California; On-site; USD 78,000 - 117,000; Full time

Job summary

Alignment Health is seeking a Senior Data Analyst to leverage data analysis, statistics, and business intelligence tools to help drive strategic decision‑making and improve operational efficiency. You will analyze data, provide actionable insights, and support various departments across Alignment Health.

The role requires 3+ years as a Data Analyst with experience in statistical modeling, data mining, and predictive analytics, plus proficiency in SQL and BI tools like Tableau/Power BI.

Qualifications

• Minimum 3 years of experience as a Data Analyst
• Two years of experience with statistical modeling, data mining, and predictive analytics techniques
• Preferred: Insurance and healthcare experience
• Required: High School Diploma or GED; Bachelor's degree or equivalent experience

Responsibilities

• Analyzes large datasets to uncover trends, patterns, and insights related to healthcare claims, member behavior, utilization, costs, and other key performance metrics.
• Designs and develops reports and dashboards using BI tools to communicate findings to stakeholders.
• Performs statistical analysis and predictive modeling to inform business decisions and identify cost-saving opportunities.
• Presents actionable insights to senior management and cross-functional teams.
• Ensures data accuracy, completeness and timeliness for analysis and reporting.

Skills

Statistical modeling

Data mining

Predictive analytics

MS Excel

Communication

Leadership

SQL

Education

High School Diploma or GED

Bachelor's degree or 4 years experience in lieu of education

Tools

Tableau

Power BI

MS Excel

Access

SQL

Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Senior Data Analyst will leverage data analysis, statistical methods, and business intelligence tools to help drive strategic decision-making and improve operational efficiency. Involves analyzing data, providing actionable insights, and supporting various departments of Alignment Health.

Key Responsibilities

1. Analyzes large datasets to uncover trends, patterns, and insights related to healthcare claims, member behavior, utilization, costs, and other key performance metrics.
2. Designs and develops comprehensive reports and dashboards using business intelligence tools (e.g., Tableau, Power BI) to communicate findings to key stakeholders.
3. Performs statistical analysis and predictive modeling to inform business decisions, identify opportunities for cost savings, and improve outcomes.
4. Presents actionable insights to senior management and cross-functional teams in a clear and concise manner.
5. Monitors and ensures the accuracy, completeness, and timeliness of healthcare data used for analysis and reporting.
6. Develops and implements data validation processes to ensure data integrity and reliability.
7. Assists in the development of data governance standards and practices to support regulatory and compliance requirements.
8. Works with various Alignment departments including Provider Contracting and Network Development staff to analyze contract rate trending impact and anomalies.
9. Identify opportunities to improve data analysis processes, tools, and techniques to enhance productivity and accuracy.
10. Stay current with industry trends, data analytics technologies, and healthcare regulations to continuously improve data-driven decision-making within the organization.
11. Supports finance and operations in developing predictive KPI’s to better forecast and manage the business of Alignment.
12. Other projects and duties as assigned.

Supervisory Responsibilities: N/A

Job Requirements

• Experience: Required: Minimum 3 years of experience as a Data Analyst. Two years of experience with statistical modeling, data mining, and predictive analytics techniques.
• Preferred: Insurance and healthcare experience.
• Education: Required: High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education.
• Preferred: MBA Training:
• Specialized Skills: Required: Knowledge of Access, SQL and/or other database programs knowledge of healthcare data types, including claims, eligibility, medical records, and encounter data. At least an intermediate level of proficiency with MS Excel (Pivot tables, VLOOKUP, etc.) Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Problem-Solving Skills: Effective problem solving, organization and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills: Comprehend and analyze statistical reports.
• Licensure: Required: None
• Other: Knowledge of principles and practices of finance administration in accounting, budgeting, and auditing. Understanding of CMS Premium payment methodologies to MA Health Plans. Understanding MMR documentation, premium payment calculations, Risk adjustment Factors (RAF), other premium adjustments, and file layout. Understanding of CMS provider payment methodologies (DRG, RBRVS, etc.) Understanding of operations, services and activities within a Data Warehouse environment (Claim Data, Membership, Eligibility, and Revenue Data, etc.) Understanding provider capitation contracts, development of capitation rates, contract carve outs, performed comparative analysis to Fee For Service. Exposure and ability to use Actuarial studies related to IBNR and LDS. Understanding of provider contracts for medical groups, independent physicians, and hospitals. Understanding of payment methodologies for Hospitals (DRG, Per Diem, % of Billed, etc.) and Physicians (RBRVS, FFS, Capitation, etc.) and other ancillary providers. Develop new analysis and approaches to the use of data that allow fresh insights into the business of the company.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. 2 The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 3 The employee frequently lifts and/or moves up to 10 pounds. 4 Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $77,905.00 - $116,858.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. Our mission-focused team makes high-quality, low-cost care a reality for members every day. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We believe that great work comes from people who are inspired to be their best. We've built a team of people who want to make a difference in the lives of the seniors we serve. Come join the team that is changing health care - one person at a time.