Senior Claims Data Analyst

October 23

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Centivo

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Healthcare Insurance

Centivo is an innovative health plan provider for self-funded employers that focuses on delivering high-quality healthcare at an affordable cost. The company believes in the power of primary care to improve health outcomes and reduce costs. Centivo offers plans with free primary care, no deductibles, and low, predictable copays, thereby encouraging members to utilize their health benefits without financial burden. The plans are curated to meet stringent price and quality standards, promoting a strong relationship with primary care providers and integrating virtual care options. Centivo's approach is designed to reduce overall medical expenses while enhancing the healthcare experience for both employers and employees.

201 - 500 employees

Founded 2017

⚕️ Healthcare Insurance

📋 Description

• Collaborate with claims and stop loss operations teams to understand analytics and reporting needs that drive efficiency and scalability. • Scope, gather, and structure requirements into actionable opportunities and solutions. • Extract, manipulate, and analyze large datasets from claims databases using SQL or similar querying languages. • Translate data into actionable insights and strategic recommendations that inform process improvements, resourcing decisions, and operational priorities. • Develop models and algorithms to identify trends, anomalies, root causes of inefficiencies and areas for operational improvement. • Design and maintain scalable dashboards and reports using tools like Tableau, Power BI, or similar platforms. • Create and monitor productivity and performance metrics to assess and enhance departmental efficiency. • Present findings to operations leadership with clear narratives that tie analytics to business outcomes. • Serve as a technical liaison between claims operations and the core data team to ensure accuracy and quality in analytics. • Develop and maintain SLA reporting to ensure claims operations meet and exceed client expectations. • Proactively identify and recommend areas for automation, workflow enhancements, and optimization across the claims lifecycle. • Ensure data integrity and accuracy across all analyses.

🎯 Requirements

• Bachelor’s degree in Data Science, Statistics, Healthcare Administration, or a related field. • 5 years of experience in data analytics, preferably within healthcare or insurance claims operations. • 5 years of experience in healthcare, claims processing, stop loss reporting and data needs and relevant regulations (e.g., ACA, HIPAA). • Proficiency in SQL with the ability to write complex queries and manipulate large datasets. • Strong skills in Python or R for data analysis and insight generation. • Strong skills in building interactive dashboards using Tableau, Power BI, or equivalent tools. • Familiarity with data warehousing and cloud platforms (e.g., AWS, Snowflake).

🏖️ Benefits

• Offers Equity • Offers Bonus