Data Analyst, Quality & Business Performance

Data Analyst, Quality & Business Performance Duration: Contract to hire • • • Please no third party candidates at this time • • • Description: The Data Analyst will be responsible for analyzing, documenting, and claims operations and business performance within the operational performance teams. This role requires a strong understanding of healthcare operations, statistical process control, standard deviation and data analysis. The ideal candidate will work closely with stakeholders to identify opportunities for improvement and implement effective solutions based on data driven trends and analyses. What You Will Do: • Analyze claims outcomes (denials, approvals, partial approvals) using industry-standard statistical process control (SPC) / control charting. • Distinguish normal variation vs. data shifts signaling further process review. • Work directly with large, scrappy data sets and • Transform raw extracts into control charts • Design, build, and conduct data analysis across multiple datasets to identify trends, patterns, and opportunities for improvement in healthcare processes. • Assist in the design and implementation of healthcare IT systems and solutions, ensuring they meet business needs and regulatory requirements. • Communicate findings and recommended actions to stakeholders (interpretation over presentation polish)Monitor and evaluate the effectiveness of implemented solutions and make adjustments as necessary. • Stay up-to-date with industry standard SPC signal rules (trend/shift/out of control) and best practices in healthcare statistical analysis. You Will Be Successful If: • Strong analytical and problem-solving skills with the ability to interpret complex data and provide actionable insights. • Proficiency in data analysis tools and software, such as advanced Excel (required), Tableau, SQL, and data visualization tools. • Knowledge of healthcare regulations, standards, and best practices, including authorization and claims editing systems. • The ideal candidate is analytical, detail-oriented, and exhibits systems thinking to troubleshoot and improve validation workflows. Experience with healthcare analytics platforms and tools. What You Will Bring: Required: • 3-5 years’ experience in a health plan, healthcare services company, or closely related industry. • 3+ years of experience in healthcare operations, authorization or claims, with a focus on quality and business performance processes. • Demonstrated ability to apply standard deviation and statistical process control (SPC)/control charting to operational outcomes • Advanced Excel skills working with large datasets (Power Query/pivots/advanced formulas preferred). • Ability to interpret variability, identify meaningful changes vs normal variation, and drill into drivers (e.g., denial reason, provider/group, LOB, time period) Bachelor’s degree in Business Administration, Healthcare Management, Information Systems, Health Informatics, or a related field or 7+ years of direct applicable experience in lieu of a degree. Preferred • SQL experience for data extraction/transformations. • Lean Six Sigma / quality improvement analytics background. • Experience with claims editing / payment integrity concepts. • Master’s degree in Health Informatics, Information Systems, Healthcare Administration, or a related field preferred. • Demonstrated expertise in clinical claims editing systems preferred. • Strong knowledge of regulatory requirements and compliance standards in healthcare, including HIPAA, CMS guidelines, and payer-specific rules preferred. • Proven track record of process improvement, automation in quality or business performance preferred. About Impresiv Health: Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges. Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it. That’s Impresiv!