Senior Decision Support Healthcare Data Analyst - Emory Health Plan

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Description

Decision Support Data Analyst, Sr (EHP) plays a pivotal role in transforming complex data into actionable insights that drive better clinical decision-making, more effective programs, and improved health outcomes for members. Operates at the intersection of clinical care, interdisciplinary data analytics, and population health strategy by conducting advanced investigative analyses, developing risk stratification models, and evaluating the effectiveness of clinical and pharmacy programs.

 

KEY RESPONSIBILITIES:

• Partners closely with Clinical, Pharmacy, Quality, Operations, Medical Management, and Technology teams to prioritize data needs and design decision-support solutions that enable evidence-based business decisions and targeted interventions.
• Translates clinical, pharmacy, and care management questions into analytical frameworks; identifies emerging risk trends; recommends innovative analytical approaches; and communicates insights to clinical and operational stakeholders in support of the Emory Health Plan's population health and value-based care (VBC) strategies.
• Conducts investigative clinical and pharmacy analyses to identify opportunities for improving health outcomes and achieving financial value.
• Evaluates the effectiveness of disease management, care management, pharmacy benefits management, and utilization management programs through rigorous outcome measurement.
• Analyzes member health data to assess member engagement, clinical quality metrics, identify care gaps, and measure program impact on key outcomes (readmissions, ED utilization, medication adherence, chronic disease control).
• Supports quality improvement initiatives by analyzing HEDIS measures, VBC metrics, and accreditation requirements.
• Develops pre/post analyses and control group comparisons to measure program ROI and clinical effectiveness.
• Builds and maintain risk stratification models to identify high-risk, rising-risk, and complex care members requiring proactive interventions.
• Conducts daily analytics to identify emerging risk trends, utilization patterns, and opportunities for early intervention.
• Supports predictive modeling efforts to forecast healthcare costs, identify members at risk for adverse events, and prioritize care management outreach.
• Analyzes member segmentation data to inform targeted program design and resource allocation decisions.
• Monitors risk score distributions, chronic disease prevalence, and population health trends across member segments.
• Determines how decision support systems will provide information required for effective clinical and business decisions across the organization.
• Partners with cross-functional teams (Clinical, Pharmacy, Quality, Medical Management, Technology) to prioritize data and information requirements.
• Translates complex clinical and operational requirements into specifications for decision support tools, dashboards, and reporting applications.
• Works with internal IT teams and external vendors to design, test, and implement analytics platforms, reporting tools, and data visualization solutions.
• Documents business rules, data definitions, and analytical methodologies to ensure consistency and reproducibility.
• Develops executive dashboards, operational reports, and clinical scorecards that provide actionable insights to stakeholders.
• Designs interactive visualizations that communicate complex clinical and financial trends to non-technical audiences.
• Builds automated reporting workflows that deliver timely data to clinical and operational teams.
• Creates ad-hoc analyses and custom reports in response to stakeholder requests and emerging business questions.
• Ensures data accuracy, completeness, and integrity in all reporting deliverables.
• Recommends innovative analytical methodologies to address complex clinical and operational challenges.
• Translates analytical findings into clear, compelling narratives that inform clinical decision-making and strategic planning.
• Presents insights and recommendations to clinical stakeholders, operations leaders, and executive teams.
• Contributes thought leadership on emerging analytics trends, best practices, and opportunities for advancing population health strategies.
• Supports a data-driven culture by educating stakeholders on how to interpret and apply analytical insights.
• Serves as a trusted analytics partner to Clinical, Pharmacy, Quality, Medica