Sr Cost Analyst

Responsible for developing and applying data science methods to improve and optimize our cost transparency solutions and develop analysis models for a variety of medical cost-related purposes. You will use and develop database extraction tools resulting in the manipulation and analysis of data specifically related to healthcare including medical claims, member eligibility, and cost data sets. If you have a healthcare background, are a proactive thinker, self-starter, who enjoys working in a fast-paced and challenging environment with the ability to work independently, this is for you.

In this position, you'll be responsible for:

  • Serving as a Subject Matter Expert for medical cost analytics.
  • Participating in the development, validation and delivery of algorithms, statistical models and reporting tools
  • Developing, validating and executing algorithms and predictive models to investigate problems, detect patterns and recommend solutions
  • Completing assigned client analytic projects by evaluating data requirements, designing analytical studies and delivering reports and results to clients and management
  • Exploring, examining and interpreting large volumes of data in various forms
  • Performing analyses of structured and unstructured data to solve complex business problems utilizing advanced statistical techniques and mathematical analyses
  • Developing data structures and pipelines to organize, collect and standardize data that helps generate insights and addresses reporting needs
  • Using data visualization techniques to effectively communicate analytical results and support business decisions
  • Creating and evaluating the data needs of assigned projects and assures the integrity of the data.
  • Documenting projects including business objectives, data gathering and processing, detailed set of results and analytical metrics
  • Liaise between technology and business partners to manage expectations and timely resolution of open items for meeting commitments
  • Identifying process areas for improvement in collaboration with technology and business operations team
  • Conducting requirement gathering sessions with SMEs, document requirements, and builds prototype (as required) to obtain stakeholder sign-off
  • Engaging with client technical resources
  • Participating in continuous product improvement initiatives by identifying opportunities to improve analytics, dashboards and data platforms

You might be a good fit if you have:

  • Bachelor’s degree in health care related, informatics, statistics or mathematics related disciplines
  • Minimum of 3 years of direct experience in health care analytics field (insurance company, hospital, consulting company, actuarial firm).
  • In-depth knowledge of health insurance-based provider billing, medical and pharmacy coding, claims payment, clinical and quality knowledge
  • Experience with quantitative analysis and strong analytical skills
  • Strong interpersonal, oral and written communication and presentation skills
  • Ability to communicate complex findings and ideas in plain language
  • Proven problem solving and change management skills
  • Motivated and flexible, able to work independently and prioritize work, operating under tight deadlines
  • Hands on knowledge of SQL, Advanced MS Excel, SSMS and Power BI

EOE Committed to Diversity

Sapphire Digital is an equal opportunity employer and does not discriminate on the basis of any legally protected class, including without limitation, race, color, religion, sex, gender, gender identity or expression, national origin, age, military service eligibility, veteran status, sexual orientation, marital status, and disability. If you need assistance or an accommodation in the hiring process we're more than happy to accommodate.