Data Analyst

WellSky is a healthcare technology company that develops solutions for Home Health and Hospice providers and payers. The Data Analyst, Value-Based Insights role transforms Medicare claims data into metrics, benchmarks, and performance measures, while building SQL-based extracts, interpreting CMS methodologies, validating data, and collaborating with product and engineering teams.

Responsibilities:

• Build and maintain claims-based data extracts and measures from CMS data sources, including the Chronic Conditions Warehouse (CCW) and Limited Data Set (LDS), to support VBI Home Health and Hospice solutions
• Develop and maintain performance measures such as HHVBP claims-based measures, MSPB-PAC, Functional Items, hospitalization/ER/PPH/DTC rates, utilization and efficiency metrics, length of stay, and composite/percentile scores
• Interpret CMS regulations and annual Final Rules (e.g., HHVBP methodology, eTPS calculations) and translate measure specifications into accurate, reproducible SQL logic
• Write and optimize SQL against large claims datasets in BigQuery; contribute to data pipelines, quarterly lookup-table refreshes, and extract automation
• Produce referral pattern, competitive analysis, market/benchmark extracts, and validate outputs against CMS public benchmarks (e.g., Home Health Compare) and client expectations
• Investigate data quality issues and metric discrepancies, and document methodology, data sources, and assumptions so results are auditable and repeatable
• Prepare data for downstream BI/visualization layers (e.g., Sisense) and collaborate with product managers and engineers to define technical requirements and analytical interpretations
• Perform other job duties as assigned

Requirements:

• Bachelor's degree in quantitative, health-informatics, or related field, or equivalent work experience
• 2–4 years of experience in data analysis, with demonstrated proficiency in SQL against large, complex datasets
• Direct experience working with Medicare/CMS claims data (e.g., CCW, LDS, LDS/RIF files, or comparable claims sources)
• Comfort with healthcare claims coding structures (e.g., ICD, HCPCS/CPT, revenue codes, DRGs)
• Ability to translate written specifications or methodologies into analytical logic and validate results for accuracy
• Willing to work additional or irregular hours as needed, particularly around quarterly CMS data refreshes and annual Final Rule cycles
• Must work in accordance with applicable security and HIPAA policies to safeguard company and client protected health information
• Must be able to sit and view a computer screen for extended periods of time
• Knowledge of Home Health and/or Hospice operations, post-acute care, or value-based care programs (e.g., HHVBP, HHVBP eTPS, hospice HIS/HOPE)
• Experience with CMS quality/value-based program methodologies and familiarity with reading CMS regulations/Final Rules
• Hands-on experience with BigQuery (or a comparable cloud data warehouse such as Snowflake) and a BI tool such as Sisense, Tableau, or Power BI
• Familiarity with risk adjustment or benchmarking concepts
• Scripting experience (e.g., Python) for data transformation and automation