Senior Manager – Diagnosis-Related Group Data Analyst

🕒 May 8

🇺🇸 United States – Remote

💵 $120k - $125k / year

⏰ Full Time

🟠 Senior

📉 Data Analyst

👻 Ghost score 56%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Pull and integrate data from disparate sources, including claims and membership/enrollment data • Perform quality assurance reviews on data and document findings • Interpret, analyze, and present key findings to internal teams and business partners • Conduct deal reviews and work with appropriate stakeholders • Publish attribution status to required stakeholders • Research attribution-related issues and coordinate with stakeholders to resolve them • Provide user guides and maintain documentation for existing attribution methodology • Help develop tools that improve attribution quality and transparency • Serve as the analytical, technical, and business co-lead • Perform coding primarily in SQL and Python

🎯 Requirements

• Bachelor's degree or equivalent experience • 5-7 years of relevant hands-on data analysis experience • 5-7 years of relevant medical claim experience • Strong understanding of inpatient MS-DRG/APR-DRG payment systems • Strong healthcare insurance data experience • Experience translating business, regulatory, and payment policy requirements into actionable code edits/rules • Experience using business tools to query large datasets, such as Microsoft SQL and Databricks • Ability to present information to technical and non-technical audiences • Ability to work with large datasets from multiple data sources • RHIA, RHIT, or CCS Certification preferred • Experience with outpatient, HH, SNF, BH, IRF, professional, DME, or HCD claims is a plus • Previous claims payment and auditing experience beneficial/recommended • Understanding of medical claim and insurance terminology • Experience with payer policy, claim system limitations, and provider contracting terms highly recommended • Experience with pre-pay and post-pay code edit/rules development recommended/encouraged

🏖️ Benefits

• Exciting, fast-paced and innovative environment • Opportunity to work closely with highly experienced, world-class analytics consultants • Opportunities to learn many aspects of clients' businesses • Training in analytics and leading analytical tools and techniques • Mentoring program with guidance and coaching • Opportunities for professional growth and development