Senior Healthcare Data Analyst - Revenue Analytics

What You Will Do - Essential Functions

The Sr Analyst, Healthcare Data will be a business consultant to the rest of the organization in providing reports and analysis to support Lucet’s clinical and operational performance. In addition, the analyst is responsible for translating evaluation questions into analytic plans, constructing analytic datasets, producing appropriate data summaries, and conducting valid data comparisons and statistical tests, with particular focus on Medicare Advantage and commercial risk adjustment programs, HCC analytics, claims and encounter data, provider documentation insights, and risk score performance.

Risk Adjustment Analytics & Performance
Lead analytics for Medicare Advantage and commercial risk adjustment programs, including HCC opportunity identification, coding gap analysis, suspecting logic, chart review support, and encounter/claims data validation.
Measure and monitor risk adjustment program performance, providing insights that drive accurate documentation, compliant coding, and improved financial and clinical outcomes.
Population Health & Clinical Collaboration
Partner with clinical strategy, care management, coding, compliance, provider engagement, and operational teams to identify target populations, define intervention cohorts, and develop actionable reporting and dashboards.
Serve as a population health consultant, analyzing member populations and recommending strategies, programs, and service offerings that improve health outcomes and care delivery.
Financial Analysis & Business Insights
Evaluate the financial impact of proposed contracts, RFPs, RFIs, and other strategic initiatives to support business decisions and organizational planning.
Analyze and report on operational, clinical, and financial data to help departments achieve objectives, meet deadlines, and support data-driven decision-making.

Who You Are

Required Qualifications
Bachelor's Degree
5+ years of experience in a similar role at healthcare payer or provider organization
Familiar with common statistical methods including but not limited to regression, propensity matching, and analysis of variance
Proficiency in database query language (e.g. SQL, SAS). Other experience with the use of software for data analysis, extraction, and manipulation (e.g., Python, R), data visualization (e.g., Tableau, PowerBI) and analytic automation (e.g. scripting, macros)
Experience with enterprise data warehouse and commercial/Medicare/Medicaid claims data
Ability to read, analyze and interpret technical materials and financial data
Must be able to present information in a small group setting with internal and external customers
Ability to perform complex arithmetic and intermediate algebra to set up spreadsheets and reports
Creates reports using advance graphical skills which can be quickly understood by the customer
Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.

Someone who embodies our values by:
Serving everyone with compassion and leading with empathy.
Stepping up and creating value by taking charge and acting when there is an opportunity.
Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
Nurturing growth and belonging by respecting and celebrating everyone for who they are.

Competencies
Practical problem-solving abilities, i.e. the ability to formulate hypotheses, test options and move forward in a fast-paced environment.
Strong analytic and data management skills
Strong oral and written communication and presentation skills
Ability to work both independently and as part of a team is essential
Ability to work well with individuals at all levels within the institution
Ability to appropriately scope and execute evaluation and analysis work

Working Conditions:
High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
Frequent use of computer and phone systems
Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
A quiet workspace with minimal background noise for calls.
For roles requiring travel, employees must be able to travel by air to various locations and stay overnight in hotels as needed for business purposes which includes ability to manage travel logistics, adapt to varying time zones and environments, and adapt to varying worksite conditions.