Sr. Analyst - Healthcare Insights & Quality

As a Senior Analyst, you’ll work with medical and pharmacy claims to build and maintain data products that support member healthcare navigation, employer compliance, and pharmacy savings initiatives. You’ll resolve data issues, respond to client inquiries, and use tools like SQL and Python to enhance analytics workflows and internal reporting. Your work will deliver accurate, actionable insights that improve decision-making, streamline operations, and drive value across the organization in a fast-paced, collaborative environment.

Things You’ll Do Here:

• Analyze medical and pharmacy claims to develop and maintain data products that support pricing, quality, and compliance tools.
• Apply advanced models and queries to resolve data issues, support client inquiries, and improve internal analytics tools and workflows.
• Use tools such as SQL, Python, Spark, and Databricks to transform complex datasets into actionable insights and clear recommendations.
• Own the development, production, validation, secure delivery, and ongoing support of outbound pharmacy data extracts for multiple vendors through SFTP and other approved data exchange methods.
• Partner with Data Engineering, Web Development, and other Analytics teams to design, deploy, and sustain complex code and workflows.
• Collaborate with different departments to investigate and resolve ad hoc cases, addressing client-specific inquiries and internal requests with accurate, data-driven responses.
• Follow production-level code release processes while driving the improvement and evolution of departmental workflows, analytics tools, and documentation.
• Continuously monitor data quality and performance, identifying trends, anomalies, and opportunities for improvement.
• Demonstrate initiative by independently managing complex tasks while contributing to a collaborative, team-oriented environment.
• Support broader strategic initiatives by delivering high-quality analysis that informs decision-making and advances organizational goals.
• Perform other duties as assigned., * Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.

• Bachelor’s degree in a quantitative field (e.g., Statistics, Mathematics, Engineering, Computer Science, Finance, or Economics) or equivalent professional experience.
• 7+ years of data analysis experience, with at least three (3) years focused on healthcare claims, including work with complex and incomplete datasets.
• Strong analytical, problem-solving, and critical-thinking skills with proven ability to uncover root causes.
• Exceptional attention to detail with a commitment to accuracy, data validation, and quality assurance.
• Highly organized and self-motivated, with the ability to manage multiple priorities independently while collaborating effectively with others.
• SQL: Proficiency in querying, transforming, and validating large, complex datasets.
• Python: Strong programming skills, including experience with data analysis and manipulation libraries (e.g., Pandas, PySpark) and automation of workflows.
• Knowledge of medical and pharmacy claims data, including coding standards (HCPCS, ICD-10, NDC) and reference datasets.
• Proficiency using Excel for validation, reporting, and quick analysis.
• Spark & Databricks: Hands-on experience with large-scale data processing and distributed computing frameworks.
• Outbound data extracts and secure data exchange: Experience creating, validating, automating, and monitoring recurring vendor data extracts and delivering files securely through SFTP or comparable approved methods.

A plus if you have:

• Master’s degree
• Cloud platforms (AWS, Azure, GCP)
• Data visualization tools (Power BI, Tableau, etc.)
• Version control (Git) and CI/CD, * Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Pulled from the full job description

• Pet insurance
• Paid parental leave
• Parental leave
• 401(k) matching
• Paid time off
• Employee discount
• Vision insurance, Full Time 1210 - Provider and Claim Analytics Experienced

Vālenz® Health is the platform to simplify healthcare - the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey - from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible., * Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.

• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors