Senior Analyst, Fraud Intelligence
Extend
NumpyPandasPythonScikit-LearnSQL
Lead Analyst – Data
Ascension Executive Recruitment
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $91,107 - $126,998 per year
Job Level
Senior
Tech Stack
CloudGoogle Cloud PlatformPythonSQLTableau
About the role
- Lead analytics and reporting for VBC Quality programs, including Stars and HEDIS measures, payer scorecards, improvement points, and performance forecasting
- Develop and maintain advanced SQL queries, Python scripts, and dashboards (Tableau, Google Sheets) to measure quality performance and identify improvement opportunities
- Translate complex business needs into actionable insights and deliverables, including reporting tools, forecasting models, and payer-aligned scorecards
- Collaborate with national, regional, and market leaders (clinical, operational, actuarial, and payer partners) to drive improvement strategies across Medicare Advantage, Medicaid, ACA, and commercial quality programs
- Monitor industry and regulatory updates (e.g., CMSv26 Stars specifications, HEDIS changes) and communicate impacts to stakeholders
- Coordinate across functional and technical teams to ensure accuracy, consistency, and optimization of reporting processes
- Recommend process improvements for efficiency and data quality
- Support payer performance reviews and audits, ensuring analytics align with contractual obligations and national quality strategies
- Mentor analysts and serve as subject matter expert in Stars/HEDIS measurement, forecasting, and payer-aligned quality performance analytics
- Translate business requests into actionable reports
Requirements
- Minimum of 4 years of healthcare analytics experience preferred
- At least 2 years of experience with payer quality programs (Stars, HEDIS, Medicaid MCO, ACA QRS, or commercial quality)
- Leadership or mentoring experience preferred
- Proficiency in SQL and Python
- Experience with Google Cloud Platform (GCP), Tableau, and Excel/Google Sheets preferred
- Strong ability to extract, transform, and interpret healthcare data from multiple sources (claims, EHR, payer reports)
- Proficiency with data extraction, manipulation, and interpretation using multiple data sources (EMR, claims, payer data)
- Preferred - Experience with HEDIS/STARs/Quality and Risk Adjustment initiatives – Healthcare Effectiveness Data and Information Set, STARS
Benefits
- Paid time off (PTO)
- Various health insurance options & wellness plans
- Retirement benefits including employer match plans
- Long-term & short-term disability
- Employee assistance programs (EAP)
- Parental leave & adoption assistance
- Tuition reimbursement
- Ways to give back to your community
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
SQLPythondata extractiondata manipulationdata interpretationforecastingreportinganalyticsquality performance measurementprocess improvement
Soft skills
leadershipmentoringcollaborationcommunicationproblem-solvinganalytical thinkingorganizational skillsattention to detailstrategic thinkingstakeholder engagement
