Healthcare EDI Analyst (Remote)
ExpediaFull Time
Mid-level (3 to 4 years), Senior (5 to 8 years)
Candidates must possess a degree in Data Analytics, Information Systems, Business Management, or a related field, or have equivalent experience. A minimum of 3 years of experience is required in defining, implementing, and evaluating process strategies and improvements, as well as working with healthcare data. Advanced proficiency in SQL, including complex queries, joins, and aggregations, is essential, along with expertise in Excel, including advanced formulas, pivot tables, and data visualization techniques. Strong analytical skills for investigating and solving complex data problems independently, experience collaborating with stakeholders to define data analysis parameters, and experience with business rule data validation and transformation are also required. Proven experience working with engineering teams in an analyst role, experience with ad hoc data analysis and ongoing metrics reporting, and the ability to translate complex data findings into actionable business insights are necessary. Experience with data validation and ETL processes, along with Microsoft Azure experience, is preferred. High attention to detail, excellent interpersonal skills, and the ability to manage multiple competing priorities in a fast-paced environment are crucial.
The Data Analyst will independently research and analyze healthcare provider and outreach data discrepancies using SQL queries and Excel-based comparisons. They will respond to urgent and exploratory data requests from stakeholders, providing timely and insightful analysis. The role involves navigating internal database structures, developing and enhancing recurring reports to track data performance, and applying critical thinking to complex data challenges. Responsibilities include translating technical data findings into business-friendly insights, writing and optimizing complex SQL queries, and building and maintaining Excel-based reports. The analyst will collaborate closely with internal teams, including engineering scrum teams, to provide data insights, identify trends indicating data integrity issues, and support improvements. Maintaining clear documentation of investigations, queries, and resolutions for knowledge sharing and process optimization is also a key duty.
Healthcare network adequacy and optimization solutions
Quest Analytics focuses on improving network adequacy and optimization in the healthcare industry. They provide advanced decision applications that assist clients, such as hospitals and health plans, in analyzing their provider networks. Their tools enable users to model networks, assess the effects of adding or removing providers, and identify gaps in coverage. This helps organizations comply with regulatory requirements and make informed decisions about their networks. Unlike many competitors, Quest Analytics combines software solutions with consulting services, generating revenue through subscriptions and consulting fees. They also offer educational events, like Quest Labs, to help clients learn and connect within the industry. The goal of Quest Analytics is to enhance the quality of care for patients by ensuring that healthcare organizations have efficient and compliant provider networks.