Job Details

Lead Data Analyst – Programming and Analytics

Location

Employment Type

Full Time, Hybrid

Requisition Number

20413

Position Summary

As a Lead Analyst (Programming & Analytics), this role will design and develop programs and reports in a Microsoft centric environment, utilizing programming language and tools such as MS SQL, T-SQL, SSRS, SSIS, C#.NET. This position will provide accurate end user information based on complex analysis. Must be able to work independently and communicate effectively with the business in a fast paced environment. Previous experience in healthcare is required, with a preference for candidates who have worked in a healthplan payer setting. Bachelor's degree or equivalent 6 plus years' experience in a related field with prior healthcare experience is a significant advantage.

Essential Duties and Responsibilities

Primary Accountability:

• Lead and mentor a team of Data Analysts, overseeing complex projects and providing strategic insights to drive business objectives.
• Review, Analyze and develop reports on a variety of projects to meet Health Plan requirements, ensuring compliance while supporting data analysis and informed decision-making utilizing the available tools like SQL, SSRS, SSIS.
• Provide professional analytical support to departments, with a primary focus on enrollment and membership, as well as payments, alongside other areas such as claims, provider networks, and utilization management (UM).
• Generates required reports and analyses in compliance with state regulations, CMS guidelines, and HIPAA requirements.
• Collaborates with internal and external clients, vendors and business partners to research, design, and develop solutions, while documenting new standard reports and processes as needed. Respond to ad hoc query requests as needed.
• Interact daily with I.T. Manager, I.T. staff, and user departments on variety of issues
• Work with other developers and analysts on appropriate architecture and design of internally developed solutions.
• Maintain appropriate records, logs and reporting of support activities
• Address CCA enrollment required changes in inbound processing, backend logics, ETL and reporting as necessary
• Provide inputs, solutions, critical research as SME for complex enrollment issues
• Oversee reconciliation process and design, update when necessary
• Collaborate with relevant business dept. heads to improve processes, resolve and prevent issues
• Maintain, update or create processes for the improvement of day-to-day work for I.T. and business depts., and create helpful guides for better process understanding
• Manage and train staff to be part of a successful team
• Other duties as assigned by IT Manager

Systems /Professional Development

• Maintains and develops professional skills through training (both company provided and self- directed), reading pertinent journals, manuals, and documentation, and participating in IT related organizations/user groups
• Provides training and assistance to other IT staff and business users in order to develop/maintain in-house expertise among all staff

Qualifications

• Bachelor's Degree in Computer Science or 6 plus years' experience in a related field.
• With extensive experience(3-4 years) on programming languages and reporting tools such as C#.NET, SQL Server, SSIS, SSRS, MS SQL, Crystal reports and other relevant technologies.
• Healthcare experience is a must preferably in Healthplan payer setting. Strong knowledge of enrollment and membership in a managed healthcare environment is essential, with additional experience in claims, provider networks, and utilization management preferred.
• Must have advanced experience working with healthcare platforms, especially in areas such as enrollment and membership including claims, provider networks and UM.
• Strong knowledge of MSSQL or other relational database systems with Data Warehouse familiarity.
• Minimum of 5 years of data reporting analysis experience
• Proficient in documentation, ensuring accurate recording of data workflows, sources, and analysis procedures to maintain consistency, transparency, and repeatability across projects.
• Must possess a proactive mindset for automation and process optimization, with a focus on increasing efficiency and reducing manual effort. Capable of automating processes using available technologies.
• Work with sensitive information with the highest degree of integrity and confidentiality
• Possess good verbal and written communication skills
• Ability to plan and work effectively
• Highly proficient with ETL, SSIS process

Physical Requirements

• Able to lift up to 30 pounds
• Use proper body mechanics when handling equipment
• Standing, walking and moving 50% of the day.

Compliance Requirements

Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.

Base Pay Scale

Ranging from $91,478-$129,189 per year.
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.