Healthcare Data Analyst

Title: Healthcare Data Analyst

Location: Remote - United States

Type: Full-time / Contract only W2 or 1099

Work Authorization: Looking for visa independent candidates as client is not able to sponsor now or in the future.

This role requires proven hands-on experience with healthcare datasets (claims/EDI, encounters, HEDIS/NCQA, EMR/EHR, HL7/FHIR). Resumes that do not demonstrate healthcare-specific data skills will not be considered.

About the Role

We are seeking a Healthcare Data Analyst with deep experience in clinical, payer, or provider data domains to support data-driven decision making across quality, compliance, population health, care management, and regulatory reporting. This role will work closely with clinicians, data engineers, business leaders, and product teams to translate complex healthcare datasets into actionable insights that improve patient outcomes and operational performance.

Key Responsibilities

Data Analysis & Reporting

Analyze large, complex healthcare datasets including EHR, EMR, claims, eligibility, encounters, lab results, pharmacy, and clinical documentation.

Build and maintain healthcare KPI dashboards for quality measures, utilization, care gaps, and cost trends.

Perform advanced statistical and exploratory data analysis to identify patterns impacting clinical or operational goals.

Domain-Specific Healthcare Data Work

Process and interpret data based on healthcare standards: HL7, FHIR, CCD/CCDA, X12/EDI (837, 835), CMS measures, HEDIS/NCQA, STAR Ratings, Risk Adjustment (HCC).

Partner with quality and compliance teams to support regulatory reporting, CMS submissions, population health programs, and value-based care analytics.

Validate and reconcile data from EHR platforms such as Epic, Cerner, Meditech, or payer systems.

Data Modeling & ETL Collaboration

Work with data engineers to improve pipelines for data ingestion, cleansing, normalization, and mapping.

Translate business requirements into SQL queries, data models, and analytical datasets.

Ensure data accuracy, completeness, and integrity across clinical and financial systems.

Required Skills & Experience

Technical Skills

SQL (advanced) – complex joins, window functions, analytical queries.

Experience using Python or R for statistical or data manipulation tasks.

Proficiency with BI tools: Tableau, Power BI, Looker, Qlik.

Experience working in data warehouses (Snowflake, Redshift, BigQuery, Azure SQL, etc.).

Healthcare Domain Expertise (must-have)

Strong understanding of claims, encounters, member data, and provider data models.

Familiarity with clinical workflows and healthcare terminology (ICD-10, CPT, LOINC, SNOMED, DRG).

Experience with HEDIS, CMS quality measures, Risk Adjustment, Population Health, or value-based care programs.

Experience with Epic Clarity/Caboodle, Cerner Millennium, or payer data systems.

Experience working with PHI/PII and knowledge of HIPAA compliance.

Knowledge of ETL/ELT pipelines and collaboration with data engineering teams.