Sr. Health Plan Operations Analyst

Design, build and maintain dashboards, productivity trackers, and KPIs utilized by leadership to improve market performance and daily operations.

Build high-complexity queries of back-end data to power dashboards and custom ad-hoc projects.

Present data findings clearly through visualization tools to ensure understanding among diverse stakeholders and colleagues.

Incorporate industry benchmarks into visual metrics (charts, graphs, pivot tables) to show baseline and current states.

Identify, monitor, and communicate changes or trends in quality and spend metrics.

Act as the first line of defense investigating, triaging, documenting, and resolving internal and external data quality issues.

Create and apply testing algorithms to evaluate large data streams throughout the system data flow.

Audit year-end performance and claims data for discrepancies, reporting errors to payer teams for swift resolution.

Source, clean, and organize data from multiple streams (payer portals, Rx claims files, SFTP sites, and internal databases).

Execute advanced SQL queries in Snowflake to supplement payer data for analysis and reporting QA.

Develop complex formulas and templates in Google Sheets and Excel to streamline repetitive data tasks.

Maintain comprehensive documentation regarding operational analytics, source-of-truth architectures, and peer cross-coverage plans.

Assist the manager with work coordination, mentoring junior analysts, developing training plans, and reviewing team work products.

Serve as a data subject matter expert (SME); attend meetings in the manager's absence.

Facilitate clear intradepartmental and cross-functional communication among key stakeholders.

Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures

Experience with statistical software, such as R or Stata

Prolonged periods of sitting at a desk and working on a computer.