Sr. Analyst - Healthcare Analytics

Role Overview

Senior Analyst (Healthcare Analytics) working with medical and pharmacy claims to build and maintain data products. The role supports member healthcare navigation, employer compliance, and pharmacy savings initiatives in a fast-paced, collaborative environment.

Responsibilities

• Analyze medical and pharmacy claims to develop and maintain data products for pricing, quality, and compliance tools.
• Use advanced models and queries to resolve data issues and respond to client inquiries.
• Transform complex datasets into actionable insights using SQL, Python, Spark, and Databricks.
• Own development, production, validation, secure delivery, and ongoing support of outbound pharmacy data extracts for multiple vendors via SFTP and approved exchange methods.
• Partner with Data Engineering, Web Development, and other Analytics teams to design, deploy, and sustain code and workflows.
• Investigate and resolve ad hoc cases and support accurate, data-driven responses to client-specific and internal requests.
• Follow production-level release processes and improve departmental workflows, analytics tools, and documentation.
• Monitor data quality and performance, identifying trends, anomalies, and opportunities to improve.
• Independently manage complex tasks while contributing to a collaborative team.

Requirements

• Bachelor’s degree in a quantitative field (or equivalent experience).
• 7+ years of data analysis experience, including 3+ years focused on healthcare claims and working with complex/incomplete datasets.
• Strong analytical and problem-solving skills with the ability to uncover root causes.
• Excellent attention to detail with commitment to data validation and quality assurance.
• Highly organized and self-motivated; ability to manage multiple priorities and collaborate effectively.
• SQL proficiency for querying, transforming, and validating large datasets.
• Python proficiency for data analysis/manipulation (e.g., Pandas, PySpark) and workflow automation.
• Knowledge of medical and pharmacy claims data, including coding standards and reference datasets (HCPCS, ICD-10, NDC).
• Proficiency using Excel for validation, reporting, and quick analysis.

Nice-to-Haves

• Strong familiarity with production data release processes and analytics documentation practices.
• Experience with healthcare data extracts and vendor data exchange workflows (e.g., SFTP).