Job description
Company Description
SpectraMedix is a leading healthcare analytics organization dedicated to empowering health plans and providers in their transition to value-based care. Our VBP Analytics Suite offers actionable insights into quality, risk, utilization, and financial performance, enabling stakeholders to execute intricate value-based arrangements effectively.
Job Title: Senior Healthcare Data Analyst
Location: East Windsor, NJ (Remote acceptable)
Experience Level: 6–8 Years
Employment Type: Full-time
Job Description
Role Overview
We are looking for an experienced Senior Healthcare Data Analyst with a strong understanding of healthcare data, payer operations, and clinical quality measurement. The ideal candidate will be proficient in SQL and have extensive experience working with HEDIS measures, claims, and payer data sets to drive performance in value-based models.
Key Responsibilities
- Analyze and report on HEDIS, eCQM, Stars, and other quality measures.
- Extract and analyze healthcare data from multiple sources (e.g., claims, enrollment, EMR).
- Develop and maintain documentation for business requirements, data mapping, and specifications.
- Work with business stakeholders to understand and deliver quality-focused data insights.
- Support UAT, data validation, and test case development.
- Collaborate with teams for planning, design, and enhancement of analytics solutions.
- Participate in internal and client reviews related to measure specifications and compliance.
Qualifications
- 6–8 years of experience as a Business/Data Analyst in US Healthcare, particularly payers or health plans.
- Proficient in SQL for data extraction and analytics.
- In-depth knowledge of healthcare codes and formats: ICD-10, CPT, HCPCS, 837I/P, HL7, FHIR.
- Hands-on experience with HEDIS, eCQMs, MIPS, DSRIP, etc.
- Strong understanding of payer data: member/enrollment, claims, revenue, risk adjustment.
- Graduate or Postgraduate degree in Public Health, Health Informatics, Hospital/Health Administration, Pharmacy, or related field.
- Strong written/verbal communication and technical documentation skills.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
Additional Information
Nice to Have
- Experience in value-based care or risk-based contracting analytics.
- Familiarity with clinical integration platforms, NCQA audit processes, or population health solutions.
