Verda Healthcare, Inc. is a Medicare Advantage Prescription Drug Plan (MAPD) organization committed to making healthcare accessible and equitable for underserved communities. This role joins a growing team focused on improving the lives of Medicare members through value-based care, data-driven decision making, and operational excellence.
The Senior Informatics Analyst leads the management and organization of healthcare data using industry-standard technologies and solutions. Working closely with Operations, Clinical, IT, and executive leadership, this position analyzes and interprets data to identify trends, create reports and visualizations, support decision making, and improve healthcare quality while reducing costs.
Key responsibilities include leading clinical decision support efforts, designing data models, integrating data from multiple sources, developing analytical trending reports, and providing oversight and quality assurance for Informatics deliverables. The role also includes mentoring team members and supporting special projects as assigned.
Qualifications
- Bachelor's degree preferred in Healthcare Informatics, Computer Science, Statistics, Mathematics, or a related field
- 3+ years of experience with T-SQL and SAS, relational databases, and/or data analytics tools such as Power BI, SSRS, or Crystal Reports
- Experience with health plan contracting or risk and capitation payment models is preferred
- Knowledge of CMS-1500 and UB-04 claim forms and claim vs. encounter data processing in managed care environments is preferred
- Knowledge of medical terminology, including ICD-10, CPT, DRG, NDC, HCPCS, modifiers, and revenue codes
- Knowledge of HIPAA transaction data including 270/271, 834, 835, and 837
- Experience with data quality, governance, and/or audit for HEDIS, STAR, and RAF is preferred
- Experience with health plan benefit interpretation is preferred
- Proficiency in Microsoft Office Suite, including Excel, PowerPoint, Project, Outlook, Word, and Visio
- Strong analytical, problem-solving, communication, and critical listening skills
- Ability to manage multiple tasks, work independently and in a team, and adapt in a fast-paced environment
- Ability to travel and work onsite full time
Benefits
- 401(k)
- Paid time off, including vacation, holiday, and sick leave
- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- Performance-based incentive compensation may be available
Location
California, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$85,000 - $100,000
Remote work allowed
No
Posted
1 month ago