Data Analyst Sr, Clinical Operations

Data Analyst Sr, Clinical Operations
CalOptima
Join Us in this Amazing Opportunity
The Team You'll Join
We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.
More About the Opportunity
We are hoping you will join us as a Data Analyst Sr, Clinical Operations and help shape the future of healthcare where you'll be an integral part of our MM - Utilization / Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework.

• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

The Data Analyst Sr (Clinical Operations) will provide analytical expertise and serve as the primary resource for developing and maintaining complex operational, programmatic and ad-hoc reports. You will be responsible for creating reports using SQL Server and BI technologies, ensuring data security and maintaining compliance with CalOptima Health policies. You will gather requirements, design and build reporting solutions and assist department teams with BI tools. Additionally, the incumbent will interpret data findings for stakeholders and contribute to reporting infrastructure improvements. Together, we are building a stronger, more equitable health system.
Your Contributions To the Team:

• 90% - Data Support

  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.

  • Serves as the primary clinical reporting and analytics resource for Clinical Operations and the CalOptima Health direct network.

  • Collaborates with the CalOptima Health delegated health networks to understand outliers in performance and health network data anomalies.

  • Provides analysis regarding trends in the data compared to prior report outcomes, industry standards and recognized benchmarks to support Clinical Operations decision-making.

  • Designs, develops, tests and implements reports/dashboards and extraction, transformation, and loading (ETL) processes to fulfill business requirements.

  • Creates complex operational, ad-hoc and program reports as needed.

  • Stays up-to-date on workflows, quality measures, regulatory requirements and department goals to align reporting and analytics.

  • Performs validation for all Clinical Operations developed reports to ensure data quality and clinical validity through validation of system and process, trend analysis and anomaly detection.

  • Supports performance improvement initiatives by identifying trends, gaps and opportunities for intervention.

  • Translates clinical questions into analytic approaches, including definitions, exclusion criteria and measures.

  • Collaborates with the CalOptima Health business departments, IS Enterprise Data and Systems Integrations and other Information Technology (IT) teams to inform and monitor the structure of clinical data within the data warehouse environment.

  • Contributes to the development of business and functional requirements for reports.

  • Supports development of reports for CalOptima Health Committees, business initiatives and quality improvement activities.
    

• 10% - Completes other projects and duties as assigned.

Do You Have What the Role Requires?

• Bachelor's degree in health care, public policy administration, business or related field PLUS 5 years of experience as a data analyst creating and validating regulatory and operational reports required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

You'll Stand Out More If You Possess the Following:

• Experience with case management and/or utilization management data, clinical systems and processes.
  

• Experience with meeting regulations from CMS, Department of Health Care Services (DHCS) and/or Department of Managed Health Care (DMHC).

What the Regulatory Agencies Need You to Possess?

• N/A

Your Knowledge & Abilities to Bring to this Role:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.

• Work independently and exercise sound judgment.

• Communicate clearly and concisely, both orally and in writing.

• Work a flexible schedule; available to participate in evening and weekend events.

• Organize, be analytical, problem-solve and possess project management skills.

• Work in a fast-paced environment and in an efficient manner.

• Manage multiple projects and identify opportunities for internal and external collaboration.

• Motivate and lead multi-program teams and external committees/coalitions.

• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Your Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.

• Ability to speak (enunciate) clearly in conversation and general communication.

• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.

• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.

• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Ways We Are Here For You

• You'll enjoy competitive compensation for this role.

  • Our current hiring range is: Pay Grade: 312 - $84,092 - $134,548 ($40.43 - $64.6865).

    • The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
      

• This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**)