Healthcare Compliance

Healthcare Compliance Data Jobs

7 jobs found

Today

Healthcare Data Analyst

Community Hospice and Palliative Care Jacksonville, FL

Jacksonville, FL

Today

$90k+/yr Full time Analytics Business Analytics Business Intelligence

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Job Description

At Community Hospice and Palliative Care, the Healthcare Data Analyst, Quality and Compliance supports mission-critical analytics that strengthen performance, quality measurement, and regulatory readiness. In this onsite role in Jacksonville, you will turn clinical, quality, operational, and compliance data into actionable insights used by quality and compliance leadership, QAPI, and survey readiness activities.

Role focus

The role reports to the Chief Compliance and Quality Officer and acts as the primary analytics resource for QAPI, compliance monitoring, regulatory reporting, and survey readiness. You will build repeatable measurement, automate reporting workflows, and support executive-level communication of quality and compliance performance.

Responsibilities

Partner with clinical and compliance leaders to define, calculate, and maintain certified quality and compliance KPIs, including documented definitions, data sources, and calculation logic in the enterprise KPI registry.
Monitor quality indicators, clinical outcomes, and performance trends across hospice, home health, palliative care, and PACE; identify variation by team, setting, and market, and explain root causes.
Analyze CAHPS data, including response trends, patient feedback themes, and demographic patterns, and support quality improvement initiatives through detailed reporting.
Work with BI Engineers and technical partners to build and maintain automated quality dashboards and scorecards, reducing manual data pulls and static spreadsheets.
Conduct conversion validation and reconciliation testing for Databricks platform and EMR transitions; document defects and confirm converted data matches source systems and certified definitions.
Provide baseline data, statistical process control, and results tracking for PIPs and QAPI performance improvement projects.
Develop predictive and early-warning analytics with clinical leaders, such as live discharge risk, length-of-stay outliers, and CAHPS decline.
Use approved AI tools (example: Claude, Microsoft Copilot, Databricks Genie) to speed analysis, comment coding, documentation, and report drafting, while verifying all AI output against source data before use.
Follow Alivia Care AI governance, HIPAA, and data privacy standards; use only approved tools with protected health information, and submit new AI use cases for governance review.
Identify manual quality and compliance processes that can be automated or AI-assisted, partnering with operations, technology, and analytics teams to prioritize and implement solutions.
Provide data and analysis for survey readiness, accreditation reviews, and compliance audits as requested by the Chief Compliance Officer.
Prepare and present executive, committee, and Board-level reports translating quality and compliance data into actionable information.
Develop executive-level dashboards, scorecards, and analytical summaries for strategic decision-making, regulatory readiness, and performance improvement.
Serve as a data resource for quality committees, the Hospice Experience Committee, and interdisciplinary meetings.
Train clinical and quality staff to read dashboards and apply data to improvement work.
Other duties as assigned.

Requirements

Bachelor’s degree in health informatics, healthcare administration, statistics, data analytics, nursing, public health, or related field (required).
3 to 5 years of healthcare data analysis experience, including quality measurement or clinical outcomes reporting.
Hospice or home health experience strongly preferred, including HOPE, CAHPS Hospice, or OASIS.
Demonstrated experience writing SQL and building dashboards in Power BI or a comparable BI tool.
Certification such as CPHQ, CHDA, Microsoft Power BI Data Analyst, or Databricks (preferred).
Proficiency in SQL and advanced Excel, including Power Query and pivot tables.
Proficiency in Power BI (or comparable BI tool), including data modeling and basic DAX.
Working knowledge of Python or R (preferred).
Familiarity with cloud data platforms such as Databricks.
Knowledge of data quality practices: validation, reconciliation, data lineage, and documentation.
Applied statistics including rates, basic risk adjustment, significance testing, and statistical process control.
Understands generative AI and predictive model limits, including inaccurate output and bias; writes effective prompts and verifies AI output against source data.
Knowledge of responsible AI use in healthcare, including HIPAA, protected health information handling, and Alivia Care AI governance policy.
Knowledge of CMS hospice and home health quality programs and survey and accreditation standards.
Experience with external platforms such as HealthPivots, NPHI, Care Compare, iQIES, and RAND.
Ability to translate clinical and operational data into clear findings and recommendations for executives.
Detail oriented with excellent written and verbal communication skills.

Technologies

SQL, Excel, Power Query, Power BI, DAX, Python, R
Databricks, Claude, Microsoft Copilot, Databricks Genie
EMR, HealthPivots, NPHI, Care Compare, iQIES, RAND
CMS quality programs, CAHPS, HOPE, OASIS, PACE

Benefits

Compensation of $90,000+ per year commensurate with experience.
Full benefits package including 23 days annual PTO.

Position details

Location: Jacksonville, FL (onsite) at Alivia Care/Community Hospice and Palliative Care non-profit headquarters, 4266 Sunbeam Road, Jacksonville FL.
Work arrangement: No work from home at this time.
Schedule: Monday to Friday, 8:00am to 5:00pm.
Compensation: $90,000+ commensurate with experience, plus full benefits package including 23 days annual PTO.

AI and governance expectations

Understands generative AI and predictive model limitations and common failure modes such as inaccurate output and bias.
Writes effective prompts and verifies AI output against source data before sharing results.
Understands responsible AI use in healthcare, including HIPAA, protected health information handling, and Alivia Care AI governance policy.

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8d ago

Data Analyst - 340B Compliance

The University of Mississippi Medical Center Jackson, MS

Jackson, MS

8d ago

Full time 340b Program Analytics Business Analytics

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Job Description

Support the University of Mississippi Medical Center’s 340B Pharmacy compliance and audit readiness through ongoing program coordination and data-driven monitoring.

Responsibilities

Conduct 340B audits and help ensure facility adherence to 340B regulations and guidelines, including Medicaid
Monitor and audit claims to support compliance with 340B Program requirements
Ensure compliance for qualified patients, drugs, and locations in coordination with the 340B compliance coordinator
Support readiness for HRSA and manufacturing audits
Develop a thorough understanding of the split-billing system and relevant functions
Educate stakeholders involved in purchasing to promote proper operation and compliance
Coordinate purchasing for split inventory across internal and contract pharmacies
Review and ensure compliance across the 340B inventory purchasing process for applicable inpatient and outpatient pharmacies
Assess opportunities for cost savings and system improvements to support higher compliance
Work to consistently improve the overall efficiency, value, and internal support of the 340B Program
Build knowledge of the healthcare and pharmacy services industry and use it to recommend improvements to the 340B Program
Develop reports to educate staff and assist management with monitoring and tracking overall financial impact and performance
Maintain copies of reports for compliance and audit purposes
Identify root causes of adverse trends and recommend corrective improvements
Maintain policies and procedures for 340B purchasing processes to support ongoing compliance
Develop policies and processes with the 340B compliance coordinator to limit program liabilities, support audits, reduce risk, prevent duplicate discounts, and prevent diversion
Develop appropriate 340B quality assurance training for employees

Requirements

Bachelor’s degree in health management, finance, business, or related field
OR High School diploma plus Four years of pharmacy tech experience that is deemed sufficient for providing leadership and ownership of 340B analyst functions
OR 1 year of 340B analyst work experience
Pharmacy Technician Registration with the Mississippi State Board of Pharmacy if using work experience in lieu of education

Technologies

Excel
Split billing software

Physical and Environmental Demands

Occasional exposure to unpleasant or disagreeable physical environment such as high noise levels and exposure to heat and cold
Occasional working hours significantly beyond regularly scheduled hours
Frequent travel to offsite locations
Occasional activities subject to significant volume changes of a seasonal or clinical nature
Frequent work produced subject to precise measures of quantity and quality
Occasional bending
Occasional lifting and carrying up to 50 pounds

Location: Jackson, MS (onsite)
Experience: 1+ years
Employment type: Full time
Pay: Hourly
FTE: 100%
Work shift: Day
FLSA designation: No
Grant funded: No
Job posting date: 10/7/2026

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1mo ago

Provider Credentialing Data Analyst

Thomas Jefferson University Hospitals Philadelphia, PA

Philadelphia, PA

1mo ago Closed

Full time Credentialing Data Analysis Data Analytics

This position is no longer accepting applications (closed Sep 19, 2026).

Job Description

Thomas Jefferson University Hospitals is seeking a Provider Credentialing Data Analyst to support credentialing activities for JMG (Jefferson Medical Group) and JeffCare PHO physicians in alignment with National Committee for Quality Assurance (NCQA) standards. This role partners with Jefferson Medical Staff to coordinate credentialing documentation through the JeffCare Credentialing Process.

Key Responsibilities

Complete primary source verification for each provider for initial credentialing and reappointments, following contractual requirements with delegated health plans, JeffCare delegated credentialing policies and procedures, NCQA, and the Department of Public Welfare.
Assemble individual physician credentialing files according to established standards.
Update and maintain demographic and credentialing information in the database.
Maintain the integrity of the Delegation Agreement.
Coordinate with Quality Assurance Representatives of health plans on JMG and JeffCare PHO enterprise credentialing policies and procedures for delegation.
Prepare physician welcome letters, manage expirables, and create or run reports and queries as required.
Manage and present materials for JeffCare Credentialing meetings, including agendas, recordings, minutes, and identifying issues, concerns, and recommendations.

Required Qualifications

High School Diploma/GED
2 years of experience in credentialing/enrollment, with delegated credentialing experience strongly preferred
Proficiency with Microsoft Office and credentialing software
Critical thinking skills with the ability to organize and prioritize work strategically
Detail oriented
Ability to multi-task and meet deadlines
Problem-solving skills, including identifying options and effective solutions to delegated credentialing questions or issues
Ability to communicate professionally with associates, partners, and leadership
Strong oral and written communication skills

Preferred Qualifications

Associate’s Degree or
Bachelor’s Degree in healthcare administration

Technologies

Microsoft Office
Credentialing software

Work Location and Schedule

Location: Philadelphia, PA (onsite)
Primary Address: 1101 Market, Philadelphia, Pennsylvania, United States of America
Work Shift: Workday Day (United States of America)
Worker Sub Type: Regular

Physical Demands

Lift and carry 25 lbs.
Frequent sitting/standing and frequent keyboard use
Patient care providers may be required to perform activities specific to their role, including kneeling, bending, squatting, and performing CPR

Benefits

Medical (including prescription)
Supplemental insurance
Dental
Vision
Life and AD&D insurance
Short- and long-term disability
Flexible spending accounts
Retirement plans
Tuition assistance
Voluntary benefits (group rates on insurance and discounts)
Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service

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2mo ago

Sr Data Analyst, Healthcare Claims Audit and Compliance

Healthfirst New York, NY

New York, NY

2mo ago Closed

$83k - $120k/yr Full time Senior Alteryx Amazon Web Services

This position is no longer accepting applications (closed Sep 11, 2026).

Job Description

Support healthcare claims audit and compliance initiatives by turning claims and configuration data into risk insights, monitoring, and reporting.

Responsibilities

Analyze complex healthcare datasets to surface trends, anomalies, control gaps, and possible compliance or operational risks
Back Internal Audit, Compliance, and Claims Configuration Audit activities using data analysis, audit testing, monitoring, and reporting
Build advanced analytical queries in SQL, SAS, or other tools to extract, validate, and analyze data from multiple sources
Assess data quality and standardize data structures to enable consistent reporting and analysis
Create and maintain dashboards, scorecards, reports, and monitoring tools with actionable insights for leadership and business stakeholders
Communicate findings, methods, and recommendations to both technical and non-technical audiences
Assist in validating claims configuration changes, business rules, and operational controls
Document analytical processes, data issues, methodologies, and business requirements
Collaborate with Internal Audit, Compliance, Claims Operations, Configuration, IT, and other business partners
Identify opportunities to improve processes, controls, and reporting through intellectual curiosity
Perform additional duties as assigned

Requirements

Bachelor’s degree from an accredited institution or equivalent work experience
3+ years of equivalent experience
Proficiency in scripting and programming
Experience with MS Office suite, including Microsoft Access, Excel, and Word
Expertise using data analysis and query tools such as SQL
Experience with Alteryx, Tableau, Amazon Redshift, or similar analytics tools/platforms
Applied statistics skills including distributions, statistical testing, regression, and related methods
Ability to successfully run queries from a data warehouse
Expertise innovating and implementing audit techniques
Excellent communication skills
Strong time management to prioritize work and complete assignments by deadlines
Experience communicating technical information in written and verbal formats to multiple levels of technical and non-technical staff
Experience managing a heavy workload in a fast-paced environment

Technologies

SQL, SAS
MS Office suite, Microsoft Access, Excel, Word
Alteryx, Tableau, Amazon Redshift, Python, R
AWS: AWS, Glue, Sage Maker
JavaScript, D3.js
Hadoop, MapReduce
AWS Kinesis

Benefits

Medical, dental, and vision coverage
Incentive and recognition programs
Life insurance
401k contributions (all benefits are subject to eligibility requirements)

Preferred Qualifications

Master’s degree from an accredited institution
Degree in Mathematics, Computer Science, Data Sciences, Engineering, Business Analytics, Informatics, or similar concentration
Experience with analytical programming techniques such as Python and R
Experience with AWS and analytical solutions available on the platform (Redshift, Glue, Sage Maker, etc.)
Familiarity with programming in JavaScript and D3.js
Familiarity with big data technologies such as Hadoop, MapReduce, and AWS Kinesis
Demonstrated ability to develop innovative solutions to complex problems using advanced problem-solving skills and sound judgment
Knowledge of modern machine learning algorithms (clustering, classification and regression), statistical methods, and optimization
Knowledge of healthcare industry systems, business strategies, and products

Compensation

Greater New York City Area (NY, NJ, CT residents): USD 83,100 - 120,360 per year
All other locations (within approved locations): USD 73,400 - 109,225 per year

Location: New York, NY (hybrid)

Minimum experience: 3 years

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2mo ago

HIM Clinical Data Analyst

Baptist Health South Florida Miami, FL 🇺🇸 Remote

Miami, FL

2mo ago Closed

$16 - $20/hr Full time Analyst Data Analysis Data Analytics

This position is no longer accepting applications (closed Sep 5, 2026).

Job Description

In this remote Florida role, you will support Baptist Health South Florida’s Health System operations across multiple care settings. Working as a clinical data analyst, you will track and trend Physician Delinquency Reports, coordinate timely notifications for pending non-compliant medical records, and provide reporting for key governance and accreditation-related meetings.

You will serve as a central point of support for 8 Acute Care Hospitals, all Baptist Outpatient Services (over 50 locations), and ambulatory surgical centers. Your work will help leadership monitor delinquency patterns, reinforce the Suspension List process, and present clear data through reports and visualizations for Medical Record Committee meetings and the Joint Commission.

Responsibilities

Provide primary Health System support for 8 Acute Care Hospitals, all Baptist Outpatient Services (over 50 locations), and ambulatory surgical centers.
Track and trend Physician Delinquency Reports.
Send timely notifications to Medical Staff regarding pending delinquent medical records and impending actions for non-compliance.
Conduct follow-up as needed, and report non-compliant physicians to key Hospital and Medical Staff Leadership to enforce the Suspension List.
Prepare reports and graphs for Medical Record Committee meetings and the Joint Commission.
Collaborate with a team to meet individual and departmental goals.

Requirements

Bachelor’s Degree in health information management, Health Services Administration, or a related field (preferred).
Preference for Certified RHIT and/or RHIA.
3+ years of experience in medical record functions in an acute care setting.
Experience with the medical record review process to ensure accurate, complete medical records according to CMS and TJC accreditation standards.
Knowledge of statistics, data collection, analysis, and data presentation.
Ability to problem solve, organize priorities, and meet objectives under time constraints with close attention to detail.
Excellent verbal and written communication skills, including effective communication with internal and external customers.
Ability to travel between hospitals to perform job duties.
Typing speed of 25 wpm and ability to pass standard testing for filing, Word, and Excel.
Ability to work under pressure, meet deadlines, maintain a positive attitude, and deliver exemplary customer service.
Ability to work independently and complete assignments within provided instructions, prescribed routines, and standard accepted practices.

Technologies

Word
Excel

Benefits

Career growth and development opportunities, with clear pathways and ongoing support.
Comprehensive health and wellness resources that go beyond traditional benefits.
A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs.
Tuition reimbursement to support continued learning and advancement.
“And so much more.”

Location: Florida (remote). Estimated pay range: $16.28 - $20.68 per hour depending on experience.

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2mo ago

Sr Data Analyst, Healthcare Claims Audit and Compliance

Healthfirst New York, NY

New York, NY

2mo ago Closed

$83k - $120k/yr Full time Senior Analyst Analytics

This position is no longer accepting applications (closed Aug 25, 2026).

Job Description

Healthfirst is expanding its Analytics team in New York, offering a Senior Analyst role focused on Audit and Compliance Analytics within healthcare claims. Based in New York with a hybrid work arrangement, the position collaborates across functions to detect risks, assess controls, and produce reporting that supports payment accuracy and operational excellence.

Responsibilities

Analyze complex healthcare datasets to reveal trends, anomalies, control gaps, and potential compliance or operational risks.
Support Internal Audit, Compliance Analytics, and Claims Configuration Audit activities through data analysis, audit testing, monitoring, and reporting.
Develop advanced SQL, SAS, or other analytical queries to extract, validate, and analyze data from multiple sources.
Evaluate data quality and standardize data structures to enable consistent reporting and analysis.
Create and maintain dashboards, scorecards, reports, and monitoring tools that provide actionable insights to leadership and business stakeholders.
Summarize findings, methodologies, and recommendations for technical and non-technical audiences.
Assist in the validation of claims configuration changes, business rules, and operational controls.
Document analytical processes, data issues, methodologies, and business requirements.
Collaborate with Internal Audit, Compliance, Claims Operations, Configuration, IT, and other business partners.
Demonstrate intellectual curiosity and identify opportunities for process, control, and reporting improvements.
Additional duties as assigned.

Requirements

Bachelor’s degree from an accredited institution or equivalent work experience
3+ years of equivalent experience
Proficiency in scripting and programming skills
Experience using MS Office suite, including Microsoft Access, Excel, and Word
Expertise in utilizing data analysis and query tools such as SQL
Experience with Alteryx, Tableau, Amazon Redshift, or other similar tools/platforms
Experience with applied statistics skills, such as distributions, statistical testing, regression, etc.
Ability to successfully run queries from a data warehouse
Expertise innovating and implementing audit techniques
Excellent communication skills
Excellent time management and the ability to prioritize work and complete assignments within their allotted deadline
Experience working with and communicating technical information to multiple levels of technical and non-technical staff in written and verbal form
Experience prioritizing a heavy workload in a fast-paced environment

Technologies

SQL
SAS
Microsoft Access
Excel
Word
Alteryx
Tableau
Amazon Redshift
AWS
Glue
SageMaker
JavaScript
D3.js
Hadoop
MapReduce
AWS Kinesis
Python
R

Benefits

Medical, dental, and vision coverage
Incentive and recognition programs
Life insurance
401k contributions

Hiring Range

Greater New York City Area (NY, NJ, CT residents): $83,100 - $120,360
All Other Locations (within approved locations): $73,400 - $109,225

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3mo ago

Mid-Level Data Scientist- Hybrid

Swingtech Greenbelt, MD

Greenbelt, MD

3mo ago Closed

Full time Analytics Big Data Business Analytics

This position is no longer accepting applications (closed Aug 14, 2026).

Job Description

Swingtech is seeking a mid-level data scientist to support a federal healthcare regulatory program based in Greenbelt, Maryland with a hybrid work arrangement. The role centers on compliance analytics, payment determination support, public reporting, and monitoring and evaluation for Medicare quality reporting.

Responsibilities

Analyze large, complex healthcare datasets to inform provider compliance determinations that feed annual payment update decisions.
Perform data cleaning, preprocessing, validation, reconciliation, and forecasting using multiple healthcare data sources.
Engineer features across diverse healthcare data sources to enable robust analyses.
Integrate and analyze data from standardized assessment systems, administrative claims, public health surveillance data, CDC data, and other approved external sources.
Develop, maintain, and enhance analytic workflows, dashboards, and reports within client approved centralized analytics on AWS platforms.
When needed, refactor legacy code into Python, SQL, or PySpark to align with federal data modernization initiatives.
Produce quarterly and annual compliance analytics, including identifying non-compliant providers and assembling program-level compliance lists.
Support monitoring and evaluation activities, including trend analysis, performance measurement, and year-over-year comparisons.
Create data visualizations and analytic summaries using cloud-based BI tools and big data analytics platforms to communicate findings to client stakeholders.
Review data dictionaries to support updates to Source to Target Mappings and implement associated change requests.
Support ad hoc data analyses to inform policy decisions, regulatory updates, and program improvements.
Document analytic methodologies, business rules, data sources, and processes in alignment with federal documentation and accessibility standards.
Collaborate with cross-functional teams using agile project management and collaboration tools to manage requirements, track work, and support timely delivery.

Requirements

Bachelor's or Master’s degree in Data Science, Statistics, Computer Science, Public Health, Health Informatics, or a related field; additional experience may be considered in lieu of a Master’s degree.
Minimum of three or more years of experience analyzing large, complex datasets from multiple sources.
Strong SQL and relational database management experience.
Experience working within cloud-based analytics environments, preferably AWS or equivalent.
Hands-on experience with Databricks, Spark, and PySpark.
Experience with data visualization tools such as cloud-based BI platforms (QuickSight, Tableau, Power BI); preference for AWS QuickSight.
Proficiency in Python and/or R for data analysis and modeling.
Familiarity with modernizing analytics platforms, including transitioning from legacy analytic solutions to open-source technologies.
Proficient use of MS Office, with advanced Excel skills.
Experience using SharePoint and the MS Office Suite, along with JIRA and Confluence.
Demonstrated experience in the healthcare industry, particularly healthcare quality measurement, outcomes research, or health services research.
Experience analyzing provider-level claims data, survey data, patient-level data, or quality reporting datasets is preferred.
Experience supporting federal healthcare programs, regulatory initiatives, or large-scale compliance programs is preferred.
Strong written and verbal communication skills, with the ability to translate complex analytic findings into clear, actionable insights for non-technical stakeholders.
Ability to work in a fast-paced, deadline-driven environment while managing multiple priorities.

Technologies

SQL
Python
R
PySpark
Databricks
Spark
AWS
AWS QuickSight
Tableau
Power BI
Excel
MS Office Suite
SharePoint
JIRA
Confluence

Benefits

15 PTO days
11 paid holidays
Medical insurance with three options, including an HSA plan with $600 employer contribution
Dental insurance with orthodontic coverage without age limits
Vision insurance through EyeMed with in-network and out-of-network coverage
Short-term and long-term disability coverage with 100% employer premium support
Life insurance and AD&D with 100% employer premium support
Supplemental life insurance
Critical care and accident insurance options
Pet insurance through Nationwide
Employee Assistance Program
401(k) with immediate enrollment and 4% employer deferral
$1500 annual training budget
$1500 referral bonus
Eligibility for annual merit and discretionary bonuses
Flexible work arrangements

Clearance / Suitability

Must be a U.S. citizen
Ability to obtain and maintain the required federal suitability or public trust clearance, as applicable

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Healthcare Compliance Data Jobs

Healthcare Data Analyst

Data Analyst - 340B Compliance

Provider Credentialing Data Analyst

Sr Data Analyst, Healthcare Claims Audit and Compliance

HIM Clinical Data Analyst

Sr Data Analyst, Healthcare Claims Audit and Compliance

Mid-Level Data Scientist- Hybrid

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