Senior Healthcare Data Analyst

About the Organization:

The Executive Office of Health and Human Services is comprised of 11 agencies and the MassHealth program.  EOHHS seeks to promote the health, resilience, and independence of the nearly one in three residents of the Commonwealth we serve. Our public health programs touch every community in the Commonwealth.  To know more about EOHHS, please visit  https://www.mass.gov/orgs/executive-office-of-health-and-human-services.   

About the Role:

Massachusetts’ Office of Medicaid (MassHealth) is looking for an exceptional Senior Healthcare Data Analyst to join the Analytics Department. The MassHealth Analytics team produces quantitative and qualitative analyses to inform business decisions at MassHealth. The selected candidate will report to the Deputy Director of Analytics and will collaborate closely with other MassHealth units to identify and answer key analytic questions to inform agency policy and operations.

The Senior Healthcare Data Analyst will work closely with MassHealth’s Program Integrity (PI) team, supporting efforts to safeguard public resources and uphold program accountability.  This role will sit at the intersection of data, compliance, and cross-agency collaboration with a focus on supporting fraud, waste, and abuse (FWA) investigations and external audits.  This position requires expertise in developing and deploying advanced SQL queries, data modeling, and predictive analytics using industry-leading visualization and statistical tools. The incumbent will design comprehensive analytical frameworks to identify complex cost and utilization drivers, develop algorithmic approaches to detect anomalies and indicators of potential FWA, and translate sophisticated analytic methodologies into actionable insights for stakeholders at all organizational levels. The Senior Analyst will serve as a technical SME to vendors to ensure they are appropriately using data to identify FWA.  The Senior Analyst may also be required to serve as a subject matter expert (SME) to cross-functional agency-wide initiatives and will be expected to work on multiple concurrent projects and complete deliverables independently. 

The primary work location for this role will be at 1 Enterprise Drive, Quincy, Massachusetts 02171. The work schedule for this position is Monday through Friday, 9:00AM to 5:00PM EST.  This position would be expected to follow a hybrid model of reporting to work that combines in-office workdays and work from home days as needed. 

Responsibilities: 

·         Analyze, design, and develop complex analytical data models.

·        Manage the delivery and reporting required by requestors. This involves working with stakeholders to define specifications based on input from program staff and testing these specifications on our data to ensure validity, working with complex eligibility, enrollment, and claims data to get answers to these questions, and then present results in a clear, concise, and accurate way that helps the agency both respond to outside inquiries and inform policymaking. This also involves managing timeframes and communicating with internal and external staff on deliverable expectations.

·         Collaborate with data warehouse staff to develop data models to aid in the use of data across the agency to inform key business decisions.

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