| Job Description: |
Roles & Responsibilities
Business & Functional Analysis
· Serve as a subject matter expert for healthcare analytics, with a strong focus on Value-Based
Care models (e.g., shared savings, capitation, quality measures).
· Translate business requirements into clear functional specifications and analytical solutions.
· Partner with business stakeholders, clinical teams, and technical teams to ensure alignment
between business needs and data outputs.
· Analyze healthcare trends across claims, member, and provider data to support performance
reviews and operational decisions.
· Provide insight into healthcare metrics such as utilization, cost drivers, quality performance, and
provider/member behavior.
Data Analysis & Reporting
· Perform complex data analysis using data from multiple healthcare sources, such as:
o Claims (medical, pharmacy)
o Eligibility and enrollment data
o Provider and member data
o Quality and performance metrics
· Design and deliver ad-hoc and recurring reports using Databricks and associated analytics
tools.
· Validate data accuracy, identify trends, anomalies, and performance gaps, and communicate
insights clearly.
Operational Support & Issue Triage
· Respond to ServiceNow (SNOW) tickets, performing triage, impact analysis, root-cause
assessment, and resolution for data and reporting issues.
· Support claims-related inquiries, including investigation of data discrepancies, processing
issues, and business-rule validation.
· Ensure timely closure of tickets with proper documentation and stakeholder communication.
Stakeholder Collaboration · Act as a trusted analyst for business users, supporting data-driven decision-making. · Clearly explain analytical findings to both technical and non-technical audiences. · Provide recommendations based on data insights to improve operational, clinical, or financial outcomes.
Key Words to search in Resume
VBC, Claims, data analytics
Pre-Screening Questionnai
Role Descriptions: Healthcare Domain SMEData Analysts
Essential Skills: Healthcare Domain SMEData Analysts
Desirable Skills:
Keyword:
Skills: Business Analysis~Healthcare Domain
Experience Required: 10 & Above |
