Senior Business Quality Analyst

Who We Are

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 60 health plans, including many of the top 20, and representing more than 160 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

Location: This role is fully remote.

About the Opportunity
 

The Senior Business Quality Analyst (BQA) analyzes medical claims, pharmacy claims, and eligibility information for healthcare companies to create database structures for mining and reporting. This analysis includes the review of complex client data layouts, providing feedback on quality and completeness, and creating mapping documents and process maps for data transformation. The Senior BQA also interprets and translates business needs into application development requirements. Finally, the Senior BQA creates or reviews analytical presentations and reports for internal and external clients. 

What you’ll do

• Validate complex extractions of medical and pharmacy claims and eligibility data, creating database mappings and structures to be utilized with mining algorithms or to meet client reporting requirements. 

• Provide timely feedback on preliminary review of healthcare client data file layouts and data integrity. 

• Define application and database requirements using interviews, document analysis, business process descriptions, use cases, scenarios, and workflow analysis. The specifications will be created in standardized templates.  

• Create and execute the testing strategy. 

• Create and run SQL queries to verify quality outcomes of database development. 

• Identifying and document mapping or other issues utilizing root cause analysis, then prioritize potential solutions based on risk and impact.  

• Communicate with a diverse group of stakeholders to understand requirements and share updates. 

• Establish project schedules and ensure project deadlines are met.  

• Bachelor’s degree in a business, technology, or related field. 

• Three to five years of experience in a business or data analyst or quality assurance role is required.  

• Experience within a healthcare-related field working with very large data sets of medical and pharmacy claims is also required. 

• Proficient in creating and troubleshooting complex SQL queries. 

• Excellent critical thinking and problem-solving skills. 

• Demonstrated attention to detail. 

• Excellent communication, time-management, and task prioritization skills. 

• Ability to build and maintain strong working relationships across the organization. 

• Ability to easily transition from one task to another and adapt quickly to change. 

This is an exempt position. The salary range is $65,000 - $85,000.

For Salary position only: The salary range is for Base Salary. Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee’s geographic location.

What’s in it for you   
 

• PTO, Paid Holidays, and Volunteer Days
• Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
• Remote and hybrid work options

At Machinify, we’re reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity, teamwork, accuracy, and flexibility. We do the right thing, and we listen to the needs of our clients and their members. As tenured experts with unmatched experience, we champion diverse perspectives