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name · Remote (United States)
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About The Role The Senior Data Analyst, Clinical Programs will be an analytically driven team player, responsible for understanding business needs and objectives, eliciting requirements from stakeholders, and analyzing data and processes to identify opportunities for improvement. This role will support BHPS Clinical Programs, Utilization Management, Complex Case Management, and Population Health Management. In this role, you will be challenged to think creatively while developing actionable insights to inform client and program strategy. Primary Responsibilities Monitor Utilization Management and Case Management activities through the development of KPIs and benchmarks (i.e. member engagement rates, readmissions, preventable hospitalizations, ER utilization) Develop statistical models that deliver meaningful insights on cost, utilization and clinical outcomes based on various data sources. Develop algorithms for stratifying populations and identifying high-risk members. Leverage Predictive Analytics to measure the performance (ROI) of Disease Management and other Medical Management programs. Conduct prospective savings analyses in support of clinical program initiatives. Build and maintain client-facing reports, dashboards, and analyses. Develop actionable data insights and advise on client strategy Participate in program performance review presentations with clinical program managers, client account managers, and external clients, as needed. Manage internal and external client requests and timelines to ensure timely delivery. Collaborate with Medical Management to provide ongoing support. Essential Qualifications Bachelors' degree required, preferably in Mathematics, Statistics, Finance, Actuarial Science, Data Science, or related field. 5-7 years of experience in healthcare analytics, preferably in a managed care setting. Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required. Proficiency in MS Excel required. Advanced data analysis, financi
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