Overview of the Role:
Alignment Healthcare is a data and technology driven healthcare company focused partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors. We are experiencing rapid growth (backed by top private equity rms), our Data Services and BI team is looking for the best and brightest leaders. Data drives the way we make decisions. We love our customers and understanding them better makes it possible to provide the best clinical outcome and care experience. We are currently seeking a Principal Data AnalystData Platform - This position will play a key role in gathering business requirements and turning them into technical requirements, competitive market/product analysis, data/AI product features & roadmap, managing several projects and uncovering deep actionable insights from data using variety of analytic tools. Alignment Healthcare is a data and technology driven healthcare company focused on partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors. We are experiencing rapid growth (backed by top private equity firms) Our Data Services and BI team is looking for the best and brightest Business Intelligence (BI) Manager. Data drives the way we make decisions. We love our customers and understanding them better makes it possible to provide the best clinical outcomes and care experiences.
Responsibilities:
- Conducting in-depth data analysis and perform data model design and data mapping activates, using spreadsheets, Visio or more specialized BI and Analytical tools.
- Work with the development team to develop a RAF calculation engine to predict the Risk scores as well as identify opportunities for Risk optimization.
- Work with Data Engineering and business team to develop strategies for identifying HCC gaps as well as built a coding application for coding team.
- Strong knowledge on Improving the encounter (EDPS) submission accuracy to achieve organization goal for CMS compliance submission for Encounter Data processing system.
- Experience in implementing data modeling based on the Data as well as care gaps and recommend solutions to optimize HEDIS rates by closing the Gaps in time.
- Experience with Healthcare data such as patient level data, claims data and provider data.
- Map data from a variety of complex data sources using a proprietary mapping tool into a EDW.
- Analyze and Validate Data to ensure the appropriate data modeling, vocabulary, terminology, and code-set standard for representing and harmonizing Healthcare data.
- Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues.
- Strong knowledge in HEDIS tools to generate HEDIS rates and submit to NCQA along with other NCQA mandated submissions.
- The liaison between Business and the Data Engineering Team.
- Work closely with the Data Engineering & BI leadership to set goals and objectives.
- Interact with different business units translate their data needs into requirements.
- Participate in project meetings, providing input to project plans and providing status updates.
- Create and maintain a positive, cohesive work environment.
Required Skills and Experience:
- 5+ years of experience Healthcare Data platforms & technologies and knowledge of Healthcare Industry standards and requirements.
- 5+ years database experience with MS SQL Server.
- 5+ years of experience in healthcare industry with proven understanding of data terminology.
- Clear understanding & working knowledge of HIPAA protocols.
- Extensive hands-on an experience with SQL Server, Azure Data Factory, APIs and other cloud-based data services.
- Extensive hands-on an experience with Power BI /SSRS or Paginated Reporting tools to demonstrate advanced analytical and reporting skills.
- Strong Healthcare Payer and clinical data Experience
- Knowledge in Python, R, or SAS programming
- Strong Data Modeling experience
- Experience in Big Data processing technologies with cloud ecosystem
- Education/Licensure:
- BS in Computer Science or other related field Engineering (Electronics), IT. Foreign Degree Equivalencies are accepted.
- Work Environment:
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Pay Range: $128,100 - $192,100.00 annually.