Job Description
Working closely with clinical and analytical colleagues, this individual will analyze complex healthcare claims, develop quality and outcomes measures, and translate clinical insight into rigorous, actionable data products. This role sits at the intersection of data science, clinical expertise, and meaningful health system impact.
Key Responsibilities:
-Integrate data from VRDC Medicare/Medicaid claims, commercial claims, EHRs, and public health sources to develop, validate, and implement quality healthcare metrics.
-Identify practice patterns that constitute excessive, inappropriate, or low-value services and quantify their prevalence and impact across provider populations.
-Partner with clinical stakeholders to 1. understand measure intent and ensure analytical outputs align with real-world care delivery context and 2. refine quality measure definitions and translate requirements into scalable, production-ready code.
-Develop and deploy statistical models to support quality measure development, trend analysis, and identification of provider practice patterns.
–Manage, prepare, cleanse, and validate data from multiple sources; document data pipelines and analytical methodologies.
–Support data acquisition and business development activities involving new data sources and external partnerships.
-Develop and deliver executive-level presentations that translate complex analytical results into actionable insights for clinical, operational, and leadership stakeholders.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
-A minimum of four years of experience in healthcare data analytics. Must have hands-on experience with healthcare claims data across Commercial, Medicare, and Medicaid payer types.
-Experience with VRDC, CMS data assets, or other government-sourced Medicare/Medicaid datasets.
-Deep familiarity with US healthcare coding systems: HCPCS, CPT, ICD-10, and DRG.
-Familiarity with HIPAA and data governance standards.
-Proficiency in SQL (query writing, aggregation, optimization across large relational datasets).
-Experience developing, validating, and deploying statistical models for healthcare analytics.
–Bachelor's degree in Statistics, Biostatistics, Public Health, Health Informatics, Computer Science, Mathematics, or a related quantitative field.
Nice to Have Skills & Experience
–Experience working in a Databricks environment, including notebook-based workflows and delta tables.
–Proficiency in Python, R, and/or SAS for statistical analysis and data processing.
–Prior exposure to quality measure development frameworks (e.g., NQF, HEDIS, or CMS measure specifications).
–Familiarity with ETL frameworks and enterprise data warehouse (EDW) environments.
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.