Senior Health Plan Operations Analyst (Healthcare)

Location: Remote, United States

Company

hirify.global's Strategic Payer Partnerships – Payer Solutions department.

What you will do

• Design, build, and maintain dashboards, productivity trackers, KPIs, charts, graphs, and pivot tables for leadership and operational performance.
• Build complex back-end data queries and present findings clearly through visualization tools.
• Investigate, triage, document, and resolve internal and external data quality issues; create testing algorithms for large data streams.
• Audit year-end performance and claims data, identify discrepancies, and report errors to payer teams.
• Source, clean, and organize data from payer portals, Rx claims files, SFTP sites, and internal databases; develop Excel and Google Sheets templates and formulas.
• Support coordination, mentoring, training, work-product reviews, subject-matter expertise, and cross-functional communication.

Requirements

• Bachelor’s degree in a related quantitative field or equivalent professional experience.
• 4+ years of experience with data management, analysis, QA, and auditing healthcare or payer data.
• Intermediate SQL programming experience; Snowflake is preferred.
• Advanced Microsoft Excel and Google Sheets skills, including complex formulas, nested functions, and pivot tables.
• Strong communication skills and the ability to collaborate effectively across remote teams.
• A proactive mindset and the ability to prioritize multiple tasks in a fast-paced environment.

Nice to have

• Understanding of value-based care, Alternative Payment Models, Medicare, and Non-MSSP quality measures.
• Experience with statistical software such as R or Stata.

Culture & Benefits

• Remote work in the United States.
• Collaboration across remote teams and multiple stakeholder groups.
• Work includes prolonged periods of sitting at a desk and working on a computer.