Authorization and Claims Analytics Data Analyst III

Location: Los Angeles, CA (onsite) • Salary: USD 88,854 - 142,166 per year • Experience: 4+ years • Education: Bachelor's Degree

Responsibilities

• Leads end-to-end analytics projects, starting with a clearly defined business case and requirements, delivering validated, actionable insights.
• Performs advanced analyses to uncover drivers of quality, efficiency, and financial performance.
• Collaborates with IT and product owners to embed analytics into enterprise systems and standard workflows.
• Builds, refines, and automates analytic assets such as data models, dashboards, and reports in line with enterprise design and refresh standards.
• Implements version control, peer review processes, and continuous integration for analytic codebases.
• Keeps data lineage and governance compliance at the forefront across analytics work.
• Oversees project planning, progress tracking, and post-implementation evaluations for assigned deliverables.
• Mentors others and demonstrates adherence to analytic development best practices.
• Leverages subject matter expertise to assess business operations and processes.
• Identifies opportunities where technical solutions could boost business performance.
• Provides cross-functional consultation, mentoring, and specialized knowledge across business operations.
• Ensures accuracy of deliverables to meet departmental, organizational, policy, standards, and regulatory requirements.
• Delivers training, suggests process enhancements, and mentors junior staff and interns as needed.
• Performs additional duties as assigned.

Requirements

• Expert in SQL for complex exploratory analysis, data modeling, and ETL supporting enterprise dashboards, reports, and analytics.
• Advanced skill with Tableau or equivalent BI tools to design, optimize, and automate dashboards and visuals for enterprise insights.
• Strong statistical acumen including multivariate analyses, regression, and control charts to identify drivers across operational, clinical, and financial performance.
• Familiarity with version control (Git, GitHub) and collaborative workflows, including peer review, CI, and reproducible analytics.
• Ability to create and maintain reusable analytic frameworks, templates, and processes for recurring reporting and performance monitoring.
• Proficiency in data validation, reconciliation, and governance, including data lineage tracking and quality control.
• Ability to translate complex business problems into analytic requirements and actionable insights.
• Ability to interpret results in the context of organization-wide performance and priorities.
• Apply critical thinking to spot patterns, opportunities, and risks across multiple data domains.
• Collaborate effectively with IT, operations, and business partners to operationalize analytics outputs.
• Solid understanding of healthcare concepts including quality measures, utilization patterns, and key operational drivers in a managed care setting.
• Capable of leading analytics projects end-to-end from business case through post-implementation assessment.
• Mentor junior analysts and promote best-practice adherence.
• Manage multiple projects concurrently, prioritize tasks, and escalate issues as needed.
• Communicate findings clearly to technical and non-technical stakeholders.
• Knowledge of claims operations, including intake, adjudication, and provider dispute resolution.
• Knowledge of clinical and financial aspects of utilization management and claims, collaborating with operations or provider teams.
• Ability to analyze operational KPIs such as turnaround times, denial rates, and appeals outcomes to derive actionable insights.

Technologies

• SQL
• Tableau
• Git
• GitHub

Benefits

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program
• Volunteer Time Off (VTO)

Physical Requirements

• Light