The Role
The role involves analyzing healthcare claims data to identify payment anomalies, developing dashboards, providing insights, and collaborating with cross-functional teams for strategic recommendations.
Summary Generated by Built In
Job Summary:
In this role, you will develop analytical insights to identify payment anomalies in client’s healthcare claims data. To be successful in the role, you will have sound knowledge and experience with Statistical Models, Data Mining, and building dashboards to deliver insights, insights communication and presentation, as well as demonstrating the ability to combine advanced analytics skills with exceptional business acumen. The Data Analyst II will collaborate with cross-functional teams to translate complex data findings into clear, concise, and actionable recommendations.
This position is only eligible for legal residents of the United States of America.
This position is a remote position.
Key Responsibilities:
Data Analysis and Interpretation:
This job description serves as a general overview of the role and is not exhaustive. The Data Analyst II may be required to perform additional responsibilities as needed to support the organization’s goals and objectives.
Who is SmartLight Analytics:
SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mind, SmartLight works for self-funded employers to reduce the wasteful spend in their healthcare plan through our proprietary data analysis. Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.
In this role, you will develop analytical insights to identify payment anomalies in client’s healthcare claims data. To be successful in the role, you will have sound knowledge and experience with Statistical Models, Data Mining, and building dashboards to deliver insights, insights communication and presentation, as well as demonstrating the ability to combine advanced analytics skills with exceptional business acumen. The Data Analyst II will collaborate with cross-functional teams to translate complex data findings into clear, concise, and actionable recommendations.
This position is only eligible for legal residents of the United States of America.
This position is a remote position.
Key Responsibilities:
Data Analysis and Interpretation:
- Develop a deep understanding of the key initiative of the organization and be able to provide analytical solutions that provides actionable recommendations to drive the success of the key initiatives.
- On-going monitoring of product lines including but not limited to the success metrics for each model and dashboards required for executive decision-making.
- Collect, clean, and analyze data from multiple sources to identify trends, patterns, and insights.
- Apply statistical methods and advanced analytical techniques to solve business challenges and provide forecasts or predictive models.
- Monitor data integrity by conducting regular audits and ensuring accuracy and completeness of datasets.
- Develop dashboards using claims and eligibility data with analytical insights to assist in executive decision making.
- Work with business stakeholders to understand their goals, challenges, and opportunities, and translate their needs into analytical projects.
- Prepare on-demand analyses and ad-hoc reports and insights.
- Present findings to stakeholders and translate insights into strategic recommendations.
- Identify opportunities to automate data processes, streamline workflows, and improve reporting efficiency.
- Document analytical methodologies, data workflows, and insights to ensure transparency and knowledge sharing across the organization.
- Communicate analytical findings and recommendations in a clear and concise way to non-technical audiences, both in oral and written presentations.
- Work closely with Information Management teams to automate recurring tasks and improve processes to continually increase efficiency.
- Education:
- Bachelor’s degree in business, economics, finance, mathematics or related field.
- Experience:
- A minimum of five (5) years of analytical work experience with healthcare claims data
- Experience and understanding of data analysis and appropriate application of these capabilities in a business performance environment
- SQL: 5+ years (Required)
- Healthcare claims: 5+ years (Required)
- Proficiency in SQL and experience with data querying and database management.
- Experience with data visualization tools such as Tableau, Power BI, or QlikView.
- Familiarity with statistical software or programming languages (e.g., R, Python, SAS, or SPSS).
- Working knowledge of ETL processes and data pipelines
- Demonstrated ability to analyze data and synthesize findings into clear insights.
- Experience with statistical analysis, forecasting, regression models, and predictive analysis.
- Strong attention to detail and a commitment to accuracy.
- Proven ability to work independently and collaboratively in a fast-paced, team-oriented environment.
- Curiosity, adaptability, and eagerness to learn and apply new technologies or methods.
- Strong written and verbal communication skills.
- Ability to present complex information in a clear, concise, and actionable manner.
This job description serves as a general overview of the role and is not exhaustive. The Data Analyst II may be required to perform additional responsibilities as needed to support the organization’s goals and objectives.
Who is SmartLight Analytics:
SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mind, SmartLight works for self-funded employers to reduce the wasteful spend in their healthcare plan through our proprietary data analysis. Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.
Top Skills
Power BI
Python
Qlikview
R
SAS
Spss
SQL
Tableau
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The Company
What We Do
SmartLight Analytics was formed by a group of industry insiders driven to make a meaningful impact on the rising cost of employee healthcare. Using our statistical, clinical, fraud detection, coding and claims expertise we deliver the most complete wasteful spend reduction solution directly to self-funded employers.
SmartLight utilizes proprietary inferential analytics customized to your employee population, followed by expert clinical review on 100% of your medical claims. Our team partners with your TPA to implement solutions resulting in a lower per employee healthcare spend. We let your data tell us where to look without any preconceived notions about what the errors are beforehand.
Our approach is low-touch and involves zero employee involvement. SmartLight consistently delivers a higher ROI compared to other cost reduction solutions on the market.
