Sr. Healthcare Informatics Analyst - Medicare Advantage

Role:- Sr. Healthcare Informatics Analyst - Medicare Advantage
Priority: Super Urgent – Highest Priority
Industry: Healthcare IT
Location: 100% Remote – Candidates must reside in a client-approved state
Employment Type: Contract
Contract Duration: 6 months, with possible extensions
Interview Process: Two video interviews
Equipment: Candidate must provide their own equipment
Key Responsibilities
Analyze Medicare Advantage trends to identify changes in healthcare utilization, medical costs, patient outcomes, and provider performance.
Perform healthcare claims analytics to identify cost drivers, utilization patterns, and opportunities for medical cost management.
Independently query and analyze large healthcare datasets using SQL and other analytical tools.
Develop analytical insights related to patient-level healthcare utilization, outcomes, and provider performance.
Evaluate risk-adjusted revenue opportunities and support Medicare Advantage risk optimization initiatives.
Analyze provider payment methodologies, population health management, and risk adjustment where applicable.
Apply statistical analysis and predictive modeling techniques to healthcare-related business problems.
Interpret analytical results and translate complex findings into clear, actionable business recommendations.
Present findings and recommendations to the Medical Cost Workgroup on a monthly basis.
Collaborate with business stakeholders and IT teams to support strategic planning and data-driven decision-making.
Support medical cost management and revenue optimization through data analysis and interpretation.
Ensure compliance with applicable laws, regulations, and organizational requirements.
Required Qualifications
1. Healthcare Analytics Experience
Healthcare experience is mandatory.
Hands-on experience with Medicare Advantage trend analysis is required.
At least four years of experience in healthcare, analytics, IT, or management consulting.
Experience working with healthcare claims data and analyzing medical cost drivers.
Understanding of the U.S. healthcare delivery system in either a payer or provider setting.
2. SQL and Data Analytics
Strong SQL skills and the ability to independently query and analyze healthcare datasets.
Experience with common analytical and visualization tools, including SQL, SAS, R, Python, Tableau, or similar technologies.
Ability to investigate complex data, identify trends, validate findings, and explain analytical results.
Experience interpreting healthcare data and converting findings into actionable business recommendations.
Recruiter priority: Strong SQL skills and healthcare claims analytics experience should be emphasized during screening.
3. Medicare Advantage Trend Analysis
Direct experience analyzing Medicare Advantage trends.
Ability to evaluate healthcare utilization, medical cost patterns, and related performance metrics.
Understanding of how analytical findings inform medical cost management, revenue optimization, and business decisions.
4. Predictive Modeling
Experience building predictive models in a healthcare analytics context.
Ability to explain the business problem addressed, tools used, modeling approach, and resulting outcomes.
Experience using tools such as SAS, R, Python, or SQL for analytical and predictive modeling tasks.
5. Education
A bachelor's degree in one of the following fields is required:
Healthcare Administration
Statistics
Economics
Analytics
Computer Science
A master's degree in a related field is preferred.
Education equivalency: Four years of related experience may be accepted in lieu of a bachelor's degree.
Important Role Clarification
The hiring manager is looking for a hands-on healthcare analytics professional who can independently analyze data, understand medical cost drivers, and communicate meaningful findings to business stakeholders.
The strongest candidates will demonstrate:
Strong SQL and healthcare claims analytics experience.
Direct Medicare Advantage trend analysis experience.
The ability to explain utilization trends and medical cost changes.
Experience translating data into actionable business recommendations.
Confidence presenting findings to business and medical cost stakeholders.
Do not prioritize candidates whose experience is primarily ETL development, dashboard creation, or AI model development without strong healthcare claims analytics and Medicare Advantage experience.
Work Authorization and Location Requirements
Eligible Work Authorization
U.S. Citizen
Green Card holder
Candidates requiring other work authorization arrangements should not be submitted unless the client confirms an exception.
Approved Remote Work States
Candidates must reside in one of the following approved states:
Alabama
Arkansas
Delaware
Florida
Georgia
Idaho
Indiana
Iowa
Kansas
Kentucky
Mississippi
Missouri
New Hampshire
Nebraska
North Carolina
Oklahoma
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
West Virginia
Wisconsin
Important: The position is 100% remote, but candidates residing outside the approved states are not eligible under the current requirements.
Candidates must also have their own computer and equipment because the client will not provide equipment.

Work arrangement
Yes