Data Analyst - Convey Health Solutions, Inc.

As a Data Analyst, you will be responsible for analyzing, interpreting, and reporting data related to Pareto’s various solutions, with a primary concentration on Pareto’s Quality solutions, which are focused on improving healthcare quality outcomes for health plans and their members. Your role will involve working with large healthcare datasets to track performance, identify trends, and provide actionable insights to improve healthcare quality scores. You will collaborate with cross-functional teams to solve complex problems and bring insights to our clients.

Key Responsibilities:

* Data Analysis and Reporting:

* Analyze healthcare data to assess the performance of healthcare plans and the outcomes of their members’ actions.

* Use statistical techniques and data tools to identify trends, gaps, and opportunities.

* Prepare and deliver regular reports on performance to internal stakeholders, highlighting key metrics, areas of improvement, and actionable insights.

* Data Quality and Accuracy:

* Ensure the accuracy, integrity, and timeliness of data related to Star Ratings and Rewards & Incentive Programs, including claims data, member surveys, administrative data and clinical performance metrics.

* Work with IT and data teams to ensure data is properly integrated and that reporting systems are configured to track, analyze and measure performance.

* Validate data to ensure it meets standards and aligns with relevant quality measures and business objectives.

* Trend Analysis and Insights:

* Conduct trend analysis to identify opportunities for improving performance.

* Provide data-driven recommendations to enhance member engagement, improve care quality, improve Plan operations, and boost performance.

* Assist in the development of strategies to improve specific performance areas.

* Collaboration with Cross-Functional Teams:

* Partner with quality improvement teams, operations, and management to translate data insights into actionable strategies.

* Collaborate with client partners to optimize the processes and initiatives that contribute to improving healthcare outcomes.

* Monitoring and Forecasting:

* Monitor ongoing data to identify potential risks or changes in performance.

* Develop forecasting models to predict outcomes and recommend actions to achieve better results.

* Assist in tracking and reporting progress.

* Regulatory Compliance:

* Stay current on CMS Star Ratings methodology and requirements to ensure that all data analysis and reporting comply with CMS standards.

* Monitor changes in Star Ratings guidelines and quality measures to assess their impact on performance and reporting processes.

Required Skills and Qualifications:

* Educational Background:

* Bachelor’s degree in Healthcare Analytics, Data Science, Statistics, Health Informatics, Public Health, or a related field.

* Experience:

* 2-4 years of experience in healthcare data analysis, with a focus on quality improvement, performance measurement, or Star Ratings.

* Experience with analyzing large datasets, including claims data, clinical data, and member satisfaction data.

* Familiarity with CMS Star Ratings and quality measures (HEDIS, CAHPS, HOS).

* Knowledge of healthcare industry standards and regulations, particularly those related to performance measurement and quality ratings.

* Skills:

* Strong proficiency in data analysis tools and software (e.g., SQL, Excel, R, Python, Tableau, Power BI).

* Advanced skills in data manipulation, statistical analysis, and reporting.

* Familiarity with healthcare data sources (e.g., claims data, survey data, electronic health records).

* Ability to present complex data findings in a clear and understandable format for stakeholders at all levels.

* Detail-oriented with strong organizational and problem-solving skills.

Preferred Qualifications:

* Experience with CMS Star Ratings, HEDIS, CAHPS, HOS data, and/or Rewards & Incentives Programs.

* Familiarity with healthcare claims management systems and data warehouses.

* Experience with predictive analytics or forecasting models.

* Knowledge of healthcare regulations, including HIPAA compliance.

REPORTING RELATIONSHIP

__X__ Position has no supervisory responsibilities

Computer Equipment and Software Requirements:

This position requires the ability to work with a personal computer in a Windows environment. Must possess strong familiarity with office software including Teams, Word, Excel, PowerPoint, and Outlook. Experience with Jupyter Hub & EMR Studio and Statistical software SAS

* Pareto utilizes Tableau for data visualization

* Microsoft SQL Server

* GitHub

* Jira & Confluence

* Lucid Chart

Convey Health Solutions: is a healthcare technology and services company that specializes in providing integrated solutions for government-sponsored health plans, including Medicare, Medicaid, and commercial plans. The company focuses on enhancing the administration, compliance, and member engagement of health plans, offering scalable and flexible solutions that support health plan operations.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled