RN Healthcare Data Analyst

RN Healthcare Data Analyst - registered nurse to leverage clinical expertise to support Certilytics products. The analyst will work with team members to conduct analyses focused on improving health outcomes and reduction of costs.

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Key Responsibilities

• Participates in Clinical Team meetings and provides analytic and statistical support for quality, clinical, and operational improvement activities, and effectively summarizing complex information
• Manipulate and analyze complex, high-volume, high-dimensional data from varying sources using a variety of tools and data analysis techniques 
• Assist with the development of reports and projects, including documenting methodology, designing reporting, and making recommendations based upon data analysis 
• Identifies complex healthcare data problems or issues, researches solutions, and implements steps to achieve higher level of efficiency for Certilytics analytics and product offerings 
• Conduct research and perform root cause analysis as part of responsibility for analytics projects
• Other tasks needed to accomplish team’s objectives/goals

Required Skills and Qualifications

• Education/Licensure: Healthcare professional degree qualification (RN.,
• Technical Skills: Proficiency in SQL, Python, R, or advanced Excel, along with experience in data visualization tools like Tableau or Power BI.
• Experience with medical and pharmacy claims data; a minimum of 1 or greater years depending on work experience -  3-year experience working with healthcare data is strongly preferred
• Analytical Skills: Ability to analyze large data sets, find patterns, and translate complex data into actionable insights for diverse stakeholders.
• Working knowledge of HIPAA requirements, NCQA®, HEDIS®, PQA, PQRS, CMS Stars and state/federal requirements for managed care is strongly preferred
• In-depth understanding of healthcare coding standards/systems (e.g. Claims, NDC, ICD 9, ICD 10, LOINC, Medications, UCUM, UMLS, SNOMED CT, etc.) with practical knowledge of clinical terminologies to create and ensure data quality standards are upheld.

Preferred Skills

·         Healthcare organization/health insurance experience/PBM’s

·         Strong analytical, problem-solving, and process skills

·         Ability to collaborate with team members and drive analytic projects end to end

·         Ability to work autonomously 

·         Knowledge of data integration, software enhancements/planning, and agile methodologies