Lead Clinical Analyst

Emploi pas sur LinkedIn

🕒 il y a 20 jours

🐊 Florida – Distant

🐊 Florida – Remote

💵 $90 000 - $100 000 / an

⏰ Temps Plein

🟠 Senior

🧐 Analyste

Postuler Maintenant

Trouver des Emplois à Distance Similaires

Recevoir des emails pour des emplois à distance

📊 Vérifiez votre score de CV pour ce poste

Améliorez vos chances d'obtenir un entretien en vérifiant votre score de CV avant de postuler.

Télécharger le CV

Health Network One

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 1999

⚕️ Assurance santé

🤝 B2B

Healthcare Insurance • B2B

Health Network One est une société de gestion de réseaux de soins de santé qui s'associe à des régimes de santé pour gérer des services spécialisés en ambulatoire (y compris la thérapie en ambulatoire, les soins oculaires de routine et médicaux, la dermatologie et la podiatrie) sous des contrats à risque total. L'entreprise opère à l'échelle nationale, couvrant plus de 7 millions de personnes et contractant avec des dizaines de milliers de prestataires, et offre des services délégués tels que la gestion de l'utilisation, l'accréditation, la gestion des réclamations et des réseaux. Health Network One met l'accent sur des solutions basées sur la valeur, la qualité clinique, la réduction des coûts pour les dépenses professionnelles et d'établissement, et détient l'accréditation NCQA et la certification HITRUST CSF.

Description

• Lead the design, development, and optimization of enterprise clinical performance dashboards (e.g., utilization, care management effectiveness, access metrics, and quality performance). • Development of recurring and adhoc analytics using SQL, Excel, and Power BI. • Translate complex clinical datasets into strategic recommendations for executive leadership, operational teams, and quality stakeholders. • Establish data validation standards and ensure accuracy, completeness, and integrity across reporting environments. • Serve as a senior subject-matter expert for clinical analytics methodologies, performance measurement, and reporting best practices. • Partner with clinical and operational leadership to define KPIs aligned with enterprise performance goals. • Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility. • Present insights and narratives to senior stakeholders in clear, decision-ready formats. • Guide prioritization of analytics initiatives supporting organizational strategy and regulatory requirements. • Mentor junior analysts and strengthen analytics capabilities across teams. • Partner with Compliance and clinical stakeholders to support state, federal and health plan reporting requirements, including NCQA, CMS, JOC. • Development of performance metrics used in audits, accreditation readiness, and compliance monitoring. • Support enterprise readiness for regulatory reviews through proactive analytics monitoring and documentation. • Drive automation of manual reporting workflows and implementation of scalable reporting solutions. • Establish documentation standards, reporting governance processes, and analytics best practices. • Lead initiatives to modernize clinical reporting infrastructure and improve enterprise data usability. • Identify opportunities to leverage analytics for performance optimization and cost-of-care improvement.

🎯 Exigences

• Bachelor’s degree (or equivalent experience) in public health, data analytics, health informatics, business, or a related field. • 5+ years of experience with advanced proficiency in SQL, Excel, and Power BI • 3+ years of experience working with healthcare datasets, including claims, utilization management/prior authorization, care management, and quality measures. • Strong understanding of clinical workflows, utilization and network management analytics, and healthcare economics. • Demonstrated ability to translate complex analytics into executive-level insights and operational recommendations. • Excellent stakeholder engagement, communication, and strategic problem-solving skills. • Self-starter with the ability to manage multiple priorities independently.