Design and conduct deep-dive analysis across multiple datasets to uncover patterns and opportunities for healthcare process improvement.
Build and maintain detailed workflows, data models, and use cases for all analytics performed.
Facilitate workshops to prioritize business needs and deliver compelling presentations that translate technical findings into executive-level recommendations.
Assist in the design and implementation of healthcare IT solutions, ensuring they meet both business goals and strict regulatory requirements.
Evaluate the long-term effectiveness of implemented solutions and pivot strategies based on data-driven results.

3–5 years in a health plan or healthcare services environment, with at least 3 years specifically focused on healthcare operations, authorizations, or claims.
Expert in Excel, specifically with Chart Control and Power Query.
Proficiency in Tableau, Power BI, SQL, and other data visualization tools.
Bachelor’s degree in Business, Health Informatics, or a related field (or 7 years of direct experience).
A Master’s degree or certifications (CBAP, CCBA, PMP) are highly preferred.
Solid understanding of HIPAA, CMS guidelines, and payer-specific rules.
A proven track record of process improvement and automation within quality or business performance workflows.

Business Analyst, Quality & Business Performance

Key skills