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GENERAL SUMMARY OF POSITION:

Under the general direction of the Director or designee, the Senior Healthcare Data Analyst will support the Office of Analytics within the Office of Medicaid (MassHealth) and support key MassHealth initiatives such as Program Integrity and Accountable Care Organizations (ACOs). The Senor Healthcare Data Analyst will be the lead analyst on complex analyses and projects and must be able to function independently, with minimal oversight. The Senior Healthcare Data Analyst will have an opportunity to inform business decisions through data analysis. This position requires skills in critical thinking relative to the relationship between the analysis being performed and the policy and programmatic questions under study. The Senior Healthcare Data Analyst will apply superior programming skills and have experience working with healthcare administrative data. He/She must be able to craft and implement analyses from business questions and communicate results clearly and effectively to program staff. The ideal candidate will have advanced data manipulation/programming and analytic skills and a passion for understanding health care programs and policy.

MAJOR RESPONSIBILITIES:

• Conduct advanced data mining as required by the program.
• Lead analyses and produce standard reports using healthcare claims data which support the development, implementation, and monitoring of MassHealth programs.
• Manipulate and build large datasets from claims and encounter data to support analyses through use of efficient SAS/SQL code.
• Utilize strong analytic consulting skills, and a customer service focus in order to design and deliver analytic projects to client specifications.
• Assist in the use of qualitative and quantitative analysis techniques.
• Utilize and create testing measures to analyze large amounts of data.
• Create algorithms to test and analyze multiple, large databases.
• Develop analyses and present information using various tools including SAS, Business Objects, SQL and Cognos and MS Office.
• Independently identify and report data patterns and abnormalities.
• Provide analysis of key metrics and data trends.
• Demonstrate exceptional analytic and problem-solving skills.
• Test, track and monitor data for quality, integrity and trends.
• Merge multiple databases and data sources to produce answers to complex business questions.
• Demonstrate attention to detail and deliver quality work products.
• Other responsibilities and projects as assigned.

REQUIRED QUALIFICATIONS:

• Bachelor's degree in healthcare, health business administration, public health, public policy, statistics or similar discipline; or equivalent.
• 5 years related or equivalent experience with proficiency in Medical Claims Analysis, Financial Data Analysis, and/or Transaction-Based Data Analysis
• Advanced knowledge of data mining software tools such as SAS, SQL, BO, Cognos or similar
• Advanced SAS/SQL programming skills
• Demonstrated knowledge of Microsoft Office Applications
• Ability to merge multiple databases and data sources to produce answers to complex business questions
• Familiarity with coding systems (i.e., CPT, ICD9, ICD10) and hospital billing systems (DRGs).
• Demonstrates intellectual curiosity, takes initiative and focuses on continuous improvement
• Ability to learn quickly and multi-task in a fast-paced, work environment
• Ability to communicate verbally and in writing in English in a clear, professional manner
• Ability to travel between locations

PREFERRED QUALIFICATIONS:

• Master’s degree in a public policy, public administration, economics, health care administration, epidemiology, statistics, or a related field
• Strong critical thinking skills
• Substantial experience working with health care claims or encounter data
• SAS certification
• Ability to learn and utilize proprietary systems and software such as NewMMIS
• Demonstrated ability to test, track and monitor data for quality, integrity and trend analysis
• Demonstrated ability to produce dashboards and monthly reports
• Demonstrated knowledge of the US healthcare system and provider billing practices
• Understanding of MassHealth or other state Medicaid programs
• Experience working in the healthcare sector, government agencies, health plan or consulting environment

ADDITIONAL INFORMATION:

The MassHealth Analytics team produces quantitative and qualitative analyses to inform business decisions at MassHealth. The selected candidate will work in the MassHealth Office of Analytics located in Quincy, MA, and will collaborate closely with other MassHealth units to identify analytic questions and key timelines.

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