Sr Data Analyst, Healthcare Claims Audit and Compliance

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