Healthcare Business Data Analyst- Health Plan

Are you looking for a career that offers both purpose and the opportunity for growth? Parkland Community Health Plan (PCHP) is a proud member of the Parkland Health family.  PCHP is a Medicaid Managed Care Organization servicing Texas Medicaid and CHIP in the Dallas Service Area.  PCHP works to fulfill of our mission by empowering members to live healthier lives.  By joining PCHP, you become part of a team focused on innovation, person-centered care, and fostering stronger communities. As we continue to expand our services, we offer opportunities for you to grow in your career while making a meaningful impact. Join us and work alongside a talented team where healthcare is more than just a job—it’s a passion to serve and improve lives every day.

Primary Purpose

Parkland Community Health Plan’s (PCHP’s) Healthcare Business Data Analyst, reporting to the Health Services department, is responsible for the gathering of data from various sources to ensure improvement in the delivery of health services. Performs data analysis, verification, and mapping of financial and clinical healthcare data related to medical, pharmacy, eligibility, and other types of data files. Oversees data mining, development, and preparation of data to provide useful information for health services department.

Minimum Specifications

Education

• Bachelor’s degree in Business, Healthcare Analytics, Computer Science, Information Systems or other related quantitative degree.

Experience

• Three years of healthcare or business-related reporting, analytics, and data analyst work.
• Two years of experience creating detailed reports for internal and external stakeholders.
• Three years of experience with data collection and analysis working with large data sets is preferred.

Equivalent Education and/or Experience

• May have an equivalent combination of education and experience to substitute for the education requirements.

Skills or Special Abilities

• Skilled in interpreting, analyzing, and providing recommendations regarding data accuracy and data collection needs and processes.
• Ability to work effectively with key stakeholders on complex cross teams and work groups.
• Able to change direction in response to changing work situations.
• Excellent problem-solving skills and an eye for details to assess and accommodate detailed project requirements.
• Strong verbal and written communication skills.
• Proficient in Microsoft Power Point, Excel, Access, and Word for data analysis and presentations.
• Ability to analyze, explain and draw logical conclusion based on complex data from multiple content areas.
• Extremely organized and able to prioritize tasks and work effectively on multiple assignments.
• Proficient in meeting NCQA medical management standards is preferred.

Responsibilities

• Responsible for the statistical analysis and production of reports, using data from a variety of sources, for use in management and/or clinical decisions. Applies appropriate statistical and validation tools to ensure data accuracy.
• Reports and presents clinical insights from the analysis of data from healthcare claims looking for discrepancies and trends in the data.
• Designs and creates clinical consulting reports with data presentations to internal and external customers as required.
• Offers suggestions on ways to improve healthcare delivery, quality and cost effectiveness for the health plan populations.
• Tracks on-going outcomes reports and manage priorities for upcoming reports.
• Responsible for information gathering from various sources and translation of information to the IT Team.

Job Accountabilities

1. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP.
2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.

Parkland Community Health Plan (PCHP) prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.