Gather requirements from stakeholders and translate to specific and actionable work tasks.
Develop complex SQL queries to support data-driven insights that inform business and clinical decisions.
Analyze healthcare data (claims, lab, pharmacy and EMR data) to draw conclusions and provide consultation to stakeholders for use in administering specific programs and operational processes.
Develop reports, dashboards, and visualizations that provide insights into various patient populations and healthcare utilization patterns.
Partner closely with clinical and operational teams to ensure data-driven decision-making and assist in the assessment of treatment concordant care.
Analyze CCS operations relative to goals and summarize the completion of routine tasks using various business unit resources.
Ensure data accuracy, quality, and integrity when working across multiple data sets.
Prepare and present findings and recommendations to leadership, internal clinical teams, and external stakeholders in support of Clover Care Services’ business initiatives.
Requirements & Skills:
A BA/BS in Mathematics, Statistics, Economics, Healthcare, or other related discipline (required).
5+ years of relevant, professional work experience (required).
Proficiency in SQL and are able to query, summarize, and manipulate data (required).
Experience working with healthcare data including but not limited to claims, lab results, and pharmacy data.
Knowledge of healthcare coding systems (ICD-10, CPT, DRG) and familiarity with healthcare quality measures (e.g., HEDIS, CMS, NCQA).
Advanced MS Office skills (Excel, Word, PowerPoint, Outlook), with a strong emphasis on Excel (required).
Experience preparing and presenting data and dashboards using data visualization tools (Tableau, PowerBI).
