Design, develop, and maintain data systems, ETLs, reports, and dashboards to meet delegated and regulatory reporting for Claims and Provider Dispute Resolution. Extract, validate, and analyze data, perform root cause analysis, support dataset architecture, and present findings to stakeholders while ensuring compliance, performance measurement, and change management.
Job Title: Business Data Analyst
Department: Ops - Claims Ops
About the Role:
This position is responsible for meeting the company's delegated and regulatory reporting requirements for both the Claims and Provider Dispute Resolution departments. Additionally, there may be occasions when support is needed to generate operational reports for these functions.
Department: Ops - Claims Ops
About the Role:
This position is responsible for meeting the company's delegated and regulatory reporting requirements for both the Claims and Provider Dispute Resolution departments. Additionally, there may be occasions when support is needed to generate operational reports for these functions.
The position involves analyzing, designing, developing, deploying, and managing data systems, reports, and dynamic dashboards. The Analyst may also be responsible for presenting analytic findings. This role includes extracting data from multiple sources, manipulating and validating the data, and may involve conducting root cause analysis.
Candidates should be comfortable performing the following tasks: writing queries in SQL Management Studio, developing reports in SQL Server Reporting Services (SSRS), writing Extract, Transform, Load (ETL) processes in SQL Server Integration Services (SSIS), creating analytical visualizations using tools such as Power BI, QlikView, and Tableau, as well as managing data systems development and enhancement projects.
What You'll Do
- Provide data analysis and reporting solutions to our various business units in support of their operational goals
- Work closely with our business units, compliance and project teams to understand reporting requirements of each of our contracted health plans, collaborate to define and document required reporting requirements, templates and cadence
- Use sound judgment in analyzing business needs and provide guidance in determining the best reporting approach (ad-hoc, scheduled, real-time, etc.)
- Implement reporting from new or existing datasets and ensure data integrity
- Provide support for new dataset creation and architecture
- Query multiple data sources using SQL, develop ETLs, and produce reports and dashboards using Power BI and SSRS
- Analyzes root cause of errors; communicates errors to the appropriate clients and escalates system errors, issues, or problems to the Business Unit Manager
- Assists in the research and evaluation of additional technical capabilities required in support of our organization’s needs
- Meets or exceeds assigned standards from a compliance timeliness and accuracy perspective
- Manages assigned escalations to resolution
- Conducts root cause analysis (project and technical) to identify opportunities for improvement
- Ensure that all forms of technical debt are identified, tracked, communicated, and addressed
- Performance Management & Control: Defines, develops, and evaluates performance metrics to establish process success, and may participate in working with multiple stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable measures of success Reviews data post- implementation to measure success; participates in defining standards of improvement success
- Change Management: Participates in and may lead change management activities associated with process improvement. Engages leadership and stakeholders to obtain support and buy in for changes. Partners with management, project champions, and process owners to align process improvement initiatives with business objectives
Qualifications
- Bachelor’s degree in Business, Mathematics, Computer Science, Information Technology, or a related field
- At least three years experience in healthcare, primarily related to Data Analysis, Database Development, or Database Administration
- Experience working with healthcare claims data, including a strong understanding of CPT codes, diagnosis codes, and dates of service
- Proficiency in SQL for querying, analyzing, and managing large datasets
- Hands-on experience developing reports and dashboards using Power BI
- Experience utilizing Databricks for data processing, analytics, and data engineering workflows
You're great for the role if:
- Experience in a Managed Care environment
- Experience with Managed Care Applications (MCA) or Healthcare Core system (EzCap or IDX)
- Experience with SSIS, Power Apps, and Power Automate is a plus
Environmental Job Requirements and Working Conditions
- This position is remotely based in the U.S. The home office is located at 1600 Corporate Center Dr. Monterey Park, CA 91754.
- The target pay range for this role is between $72,000.00 - $84,000.00. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
About
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
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