Senior Healthcare Analyst

This is Vilayath Khan a Certified LinkedIn Recruiter with Clevanoo LLC, We have an immediate need Senior Healthcare Informatics Analyst. If you are available and interested in below remote position. Please reply with your updated resume in word format and the best number to reach you. Senior Healthcare Informatics Analyst Fully Remote 6-12+ Months W2 Contract Position Overview We are seeking an experienced Senior Healthcare Informatics Analyst to provide advanced healthcare analytics that drive a deeper understanding of how healthcare is valued, utilized, and delivered. This role will focus heavily on trend analysis, healthcare data insights, predictive modeling, provider performance measurement, medical cost management, and risk-adjusted revenue optimization.The ideal candidate will have a strong healthcare analytics background, preferably within a payer environment, and experience supporting Medicare Advantage programs. This individual will collaborate with business leaders, IT teams, actuaries, clinical departments, and external partners to develop data-driven solutions that support strategic decision-making. Ideal Candidate The ideal candidate brings a strong blend of healthcare analytics, predictive modeling, trend analysis, and Medicare Advantage experience, with the ability to transform complex healthcare data into actionable business insights that improve outcomes, reduce costs, and support strategic decision-making. Position Details Equipment: Candidate must provide their own equipment. Louisiana Blue equipment will not be provided. Approved States Candidates must currently reside in one of the following states: • Alabama • Arkansas • Delaware • Florida • Georgia • Idaho • Indiana • Iowa • Kansas • Kentucky • Mississippi • Missouri • New Hampshire • Nebraska • North Carolina • Oklahoma • Pennsylvania (excluding Allegheny, Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) • South Carolina • South Dakota • Tennessee • Texas • Utah • Virginia • West Virginia Required Qualifications Must-Have Experience • Healthcare industry experience required • Medicare Advantage experience strongly preferred • Strong trend analysis experience • Experience working within healthcare analytics, informatics, payer, provider, consulting, or healthcare IT environments Education • Bachelor's degree in: • Healthcare Administration • Statistics • Economics • Analytics • Computer Science • Or a related field Preferred: • Master's degree in a related field Substitution: • Four years of related experience may substitute for a Bachelor's degree Experience Requirements • Minimum 4 years of experience in: • Healthcare analytics • Healthcare IT • Consulting • Data analysis • Healthcare operations Education Substitutions: • Master's degree may substitute for 2 years of required experience • Doctorate degree may substitute for an additional 2 years of required experience Key Responsibilities • Lead the selection and implementation of analytical, business intelligence, and evaluation methodologies. • Develop analytics supporting: • Patient utilization and outcomes • Provider performance measurement • Risk-adjusted revenue optimization • Medical cost management • Population health initiatives • Patient and provider engagement strategies • Design and develop predictive models, BI solutions, and analytical attributes. • Collaborate with Clinical Solutions, Clinical Partnerships, IT, Actuarial, Provider Reimbursement, Marketing, and Payment Innovation teams. • Analyze data from Enterprise Data Warehouse (EDW) and non-EDW data sources. • Translate business requirements into analytical models and actionable insights. • Conduct advanced descriptive and statistical analyses. • Perform data validation and peer reviews to ensure the accuracy, consistency, and quality of outputs. • Serve as a trusted analytics advisor on strategic and cross-functional initiatives. • Present findings and recommendations to business and executive stakeholders. Required Technical Skills Analytics & Data Tools Strong working knowledge of: • SQL • SAS • R • Python • Tableau • Business Intelligence and visualization tools Healthcare Analytics Expertise Preferred experience with: • Predictive modeling • Outcome research design • Controlled study design • Healthcare utilization analytics • Population health management • Medical cost analysis Preferred Healthcare Knowledge Strong understanding of: • Provider payment methodologies • Risk adjustment programs • Population health management • Commercial risk optimization • Medicare Advantage risk optimization Clinical & Quality Metrics Experience with: • HEDIS • AHRQ • Risk grouping methodologies • Clinical grouping methodologies including: • DRG • APC • ETG • MEG • DxCG • HCC Additional Preferred Skills • SAS Enterprise Miner • Advanced statistical analysis • Data quality management • Healthcare payer operations Required Competencies • Strong analytical and critical-thinking skills • Advanced problem-solving capabilities • Excellent written and verbal communication skills • Ability to communicate complex technical concepts to both technical and non-technical audiences • Strong stakeholder management skills • Ability to work independently with minimal supervision • Experience influencing strategic business decisions through data-driven insights Organizational Partnerships This role regularly collaborates with: • Clinical Solutions • Clinical Partnerships • Actuarial Teams • Provider Reimbursement • Payment Innovation • Enterprise Information Management (EIM) • Information Technology (IT) • Marketing • External Vendors • Blue Cross Blue Shield Association • Other BCBS Plan Partners Work Environment • Fully remote position • Standard office environment • Primarily seated computer-based work • Ability to analyze, calculate, document, visualize, and interpret complex data is required • Additional duties may be assigned within the scope of the role