health care analyst

State of Florida

<div><p>Requisition No: 872407</p>
<p>
Agency: Agency for Health Care Administration</p>
<p>
Working Title: 68064693 - MEDICAL HEALTH CARE PROGRAM ANALYST</p>
<p>
 Pay Plan: Career Service</p>
<p>
Position Number: 68064693</p>
<p>
Salary: $1,833.39 Biweekly</p>
<p>
Posting Closing Date: 04/01/2026</p>
<p><b>
Total Compensation Estimator </b><b>Tool</b></p><p>
This is a full-time career service position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5:00 p.m.
</p><p><b>This Medical Health Care Program Analyst position is anticipated to be filled at a rate of $1,833.39 b/w and is non-negotiable.
</b></p><p>This position may involve travel-related activities from 1-15%.
</p><p>Successful completion of a criminal background investigation is a condition of employment.
</p><p>A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive.
</p><p>The individual in this position is expected to report to work daily and on time.</p><br>
<p></p>
<p>
The Florida Medicaid program is one of the five largest in the country and has an estimated $38 billion annual budget. Each month Florida Medicaid covers medical services for almost 4 million recipients.
</p><p>To most effectively serve this large patient population, one of the Agency goals is to ensure fewer budgeted dollars are lost to fraud, abuse, and waste.
</p><p>The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal violations for law enforcement investigation.</p><br>
<p>
</p><p>This Medical Health Care Program Analyst position will support the fraud and abuse prevention efforts within the Bureau of Medicaid Program Integrity (MPI).</p><br>
<p>
</p><p>MPI is organized by the functions that fall within the Bureau&rsquo;s responsibility: Fraud and Abuse Detection, Prevention, Overpayment Recovery, and Managed Care oversight.
</p><p>MPI operates with dynamic and fast-paced units that work closely with one another to serve the overall bureau mission.
</p><p>To address the complexity and scope of fraudulent and abusive behavior in the Florida Medicaid program, these units are responsible for developing novel methods and technologies to fight fraud, abuse, and waste.
</p><p>To do this, these highly collaborative and innovative units rely on teams with diverse educational and experience backgrounds.</p><br>
<p></p>
<p>
The candidate selected for this position is responsible for identifying, investigating, and supporting the prevention of fraud, waste, and abuse with a primary focus on Durable Medical Equipment and Supplies (DME).
</p><p>The position conducts complex claim analysis, performs targeted provider clinical and compliance reviews of records, evaluates compliance with Medicaid policy, state rules and laws, federal regulations, and maintains ongoing knowledge of emerging trends, policies, rules, laws, and federal regulations relevant to program integrity, and DME providers and services.
</p><p>The selected candidate will also represent the Agency as a subject matter expert during administrative hearings.</p><br>
<p></p>
<p>
The selected candidate may be responsible for conducting investigations/audits to identify aberrant billing patterns, improper utilization, and potential fraud or abuse within DME claims, writing summary reports, and making referrals to other entities involving Medicaid providers or issuing audit reports in accordance with state and federal rules, laws, and statutes.
</p><p>The selected candidate will also be responsible for working collaboratively with other MPI operational units and participating in special projects, compliance site visits, and inspections.
</p><p>The candidate will also be responsible for utilizing open-source and proprietary resources to conduct the audits, investigations and related administrative actions, as well as monitoring and tracking the associated case status.</p><br>
<p>
</p><p>This position requires a broad array of knowledge and experience specifically related to fraud prevention programs, compliance assessment, case management, legal analysis, and the investigative process as well as a desire to innovate.
</p><p>The selected candidate will assist in conducting investigations/audits related to fraud, abuse, and waste through research and analysis of complex health and business-related records.
</p><p>Included in the functions of this position are activities such as:</p><br>
<p></p>
<ul><li>Conducting desk or onsite records reviews to determine documentation sufficiency, and compliance with Medicaid provisions, state laws and rules, and federal regulations.</li></ul>
<ul><li>Developing findings and recommendations for overpayment recoveries, assessing sanctions, and making referrals to law enforcement partners.</li></ul>
<ul><li>Interpreting claims in the context of clinical standards, policy requirements, and expected utilization patterns.</li></ul>
<ul><li>Identifying deficiencies, patterns of noncompliance, and opportunities for provider education or corrective action.</li></ul>
<ul><li>In collaboration with agency counsel, preparing testimony, exhibits, and expert statements that articulate clinical rationale, policy interpretation, and audit or investigative findings.</li></ul>
<ul><li>Collaborating with team members on projects and assignments.</li></ul>
<ul><li>Providing internal consultation and training on claim decisions, rules and guidelines, and issues related to program integrity of DME providers and services.</li></ul><br>
<p></p>
<p>
Benefits of Working for the State of Florida:</p>
<p>
Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including:</p>
<ul><li>Health insurance (i.e., individual and family coverage) to eligible employees</li></ul>
<ul><li>Life insurance; $25,000 policy is free plus option to purchase additional life insurance</li></ul>
<ul><li>Dental, vision and supplemental insurance</li></ul>
<ul><li>State of Florida retirement options, including employer contributions</li></ul>
<ul><li>Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida</li></ul>
<ul><li>Ability to earn up to 104 hours of sick leave annually</li></ul>
<ul><li>Nine paid holidays and 1 personal holiday each year</li></ul>
<ul><li>Opportunities for career advancement</li></ul>
<ul><li>Tuition waivers (accepted by major Florida Colleges/universities)</li></ul>
<ul><li>Student loan forgiveness opportunities (eligibility required)</li></ul>
<ul><li>Training opportunities</li></ul>
<ul><li>Flexible Spending Accounts</li></ul>
<ul><li>Shared Savings Program for select medical services</li></ul>
<ul><li>Lower copays for prescription drugs</li></ul>
<ul><li>Health and Wellness discounts</li></ul>
<p>
For a more complete list of benefits, please visit https://www.mybenefits.myflorida.com/</p><br>
<p></p>
<p><b>
KNOWLEDGE, SKILLS, AND ABILITIES</b></p>
<ul><li>Ability to solve problems and make decisions based on available information.</li></ul>
<ul><li>Ability to execute projects and assignments timely and accurately within a fast-paced environment.</li></ul>
<ul><li>Ability to conduct investigations, coordinate investigative activities, and accurately document the result of an investigation.</li></ul>
<ul><li>Ability to conduct fact finding research.</li></ul>
<ul><li>Ability to work independently.</li></ul>
<ul><li>Ability to communicate effectively verbally and in writing.</li></ul>
<ul><li>Ability to review and comprehend applicable federal and state laws, rules, policies, and regulations related to health care and enforcement activities.</li></ul>
<ul><li>Ability to demonstrate proficiency using Microsoft Word, Excel, Outlook, PowerPoint, SharePoint.</li></ul>
<ul><li>Ability to travel with or without accommodation.</li></ul>
<ul><li>Ability of strong research skills, written and oral communication skills, and organizational skills.</li></ul>
<ul><li>Knowledge of the Florida Medicaid Program.</li></ul>
<ul><li>Knowledge of research or investigative principles, practices, and techniques.</li></ul><br>
<p></p>
<p><b>
MINIMUM QUALIFICATIONS REQUIREMENTS</b></p>
<ul><li>Two years of professional or nonprofessional experience in a regulatory or health service setting.</li></ul>
<ul><li>An associate&rsquo;s degree from an accredited college or university can substitute on a year for year basis in a related field such as health law, health science, health services administration, business administration, public administration, sociology, criminology, criminal justice, or a substantially similar discipline.</li></ul>
<ul><li>Preference will be given to candidates with a coding certification, such as Certified Professional Coder, Certified Coding Specialist, Certified Professional Biller, Certified Professional Medical Auditor or other relevant equivalent.</li></ul>
<ul><li>Preference will be given to candidates with respiratory therapy, occupational therapy, physical therapy, nursing, or durable medical equipment and supply setting experience.</li></ul><br>
<p></p>
<p><b>
LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS</b></p>
<p>
N/A</p><br>
<p></p>
<p><b>
CONTACT:</b> HELEN GUNN 850-412-4626</p><br>
<p></p>
<p><b>
BACKGROUND SCREENING
</b></p><p>It is the policy of the Florida Agency for Health Care Administration that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S. No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency. Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies.</p><p>
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.</p>
<p>
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.</p>
<p><b>
VETERANS&rsquo; PREFERENCE. </b>Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans&rsquo; Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans&rsquo; Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans&rsquo; Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.</p></div>

MEDICAL HEALTH CARE PROGRAM ANALYST

University of South Carolina

<p></p><div><div><div><div><div><div><div><div><b>Posting Number</b></div> <div>RTF00041PO26</div>
</div><br>
<div><div><b>USC Market Title</b></div> <div>Sr. Research Associate</div>
</div><br>
<div><div><b>Link to USC Market Title</b></div> <div>https://uscjobs.sc.edu/titles/169217</div>
</div><br>
<div><div><b>Business Title (Internal Title)</b></div> <div>MCH Health Care Data Analyst</div>
</div><br>
<div><div><b>Campus</b></div> <div>Columbia</div>
</div><br>
<div><div><b>Work County</b></div> <div>Richland</div>
</div><br>
<div><div><b>College/Division</b></div> <div>College of Social Work</div>
</div><br>
<div><div><b>Department</b></div> <div>COSW Institute for Families in Society</div>
</div><br>
<div><div><b>Anticipated Hiring Range</b></div> <div>$80,000</div>
</div><br>
<div><div><b>Location of Vacancy</b></div> <div>Columbia, SC</div>
</div><br>
<div><div><b>Part/Full Time</b></div> <div>Full Time</div>
</div><br>
<div><div><b>Hours per Week</b></div> <div>37.5</div>
</div><br>
<div><div><b>Work Schedule</b></div>
<div><ul><li>Monday through Friday, 8:30am until 5:00pm.</li></ul><p></p><div><br>
</div><ul><li>
Must be willing to work a flexible schedule to meet the needs of the department.</li></ul></div>
</div><br>
<div><div><b>Type of Staff Position</b></div> <div>Staff Research Grant (SRGP)</div>
</div><br>
<div><div><b>Basis </b></div><div>12 months</div>
</div><br>
<div><div><b>Job Search Category</b></div> <div>Information Technology</div>
</div><br>
</div></div></div><div><div>About USC
</div><p></p><div><div><div><div><b>About University of South Carolina</b></div>
<div>From the Upstate to the Lowcountry, the University of South Carolina system is transforming the lives of South Carolinians through the impact of our eight institutions and 20 locations throughout the state. More than 50,000 students are enrolled at one of eight institutions, including the research campus in Columbia and comprehensive four-year universities in Aiken, Upstate and Beaufort. In addition, our Palmetto College campuses in Salkehatchie, Union, Lancaster and Sumter enable students to earn associate or bachelor&rsquo;s degrees through a combination of in-person, online or blended learning. All of our system institutions place strong emphasis on service &mdash; helping to build healthier, more educated communities in South Carolina and beyond.</div>
</div><br>
</div></div></div><div><div>Benefits for Research Grant or Time-Limited Positions Are Indicated Below
<p>The University of South Carolina (UofSC), through the State of SC and Public Employee Benefit Authority (PEBA), offers employees a valuable benefits package, including health and life insurance, generous paid leave and retirement programs. To learn more about UofSC benefits, access the &quot;Working at USC&quot; section on the Applicant Portal at https://uscjobs.sc.edu. Research Grant or Time-limited positions may be eligible for all, some, or no benefits, based on the grant or project funding.</p>
</div><div><div><div><div><b>South Carolina Retirement</b></div> <div>Yes</div>
</div><br>
<div><div><b>State Insurance Programs</b></div> <div>Yes</div>
</div><br>
<div><div><b>Annual Leave</b></div> <div>Yes</div>
</div><br>
<div><div><b>Sick Leave</b></div> <div>Yes</div>
</div><br>
</div></div></div><div><div>Position Description
</div><p></p><div><div><div><div><b>Advertised Job Summary</b></div>
<div>The Senior Research Associate/MCH Health Care Data Analyst provides high-level professional healthcare claims analytics work related to Medicaid and conducts quantitative analyses that support health care projects and research activities focused on Maternal and Child Health (MCH) populations.</div>
</div><br>
<div><div><b>Job Related Minimum Required Education and Experience</b></div>
<ul><li>Requires a master&rsquo;s degree in area of research specialty and five years of job related experience.</li></ul>
</div><br>
<div><div><b>Required Certification, Licensure/Other Credentials</b></div>
</div><br>
<div></div><div><div><b>Preferred Qualifications</b></div>
<ul><li>Experience/training in health services research.</li>
<li>At least 4 years of experience with the analysis of claims/encounter data.</li>
<li>Strongly prefer an understanding of Medicaid, Medicare, and/or private healthcare claims data systems.</li>
<li>Understanding of and/or experience with analysis of electronic health record data, including data elements used in MCH contexts.</li>
<li>Strong proficiency in SAS, SQL, R, and Python.</li>
</ul>
</div><br>
<div><div><b>Knowledge/Skills/Abilities</b></div>
<ul><li>Strong analytical thinking and attention to detail.</li>
<li>Experience with large relational database administration.</li>
<li>Demonstrated experience in data management and analysis with administrative data, including health or behavioral healthcare claims such as Medicaid, Medicare, private insurance data, or state agency and national datasets; experience with relevant MCH populations preferred.</li>
<li>Proficiency in SAS, SQL, and other statistical analytical software programs (e.g., R, Python).</li>
<li>Demonstrated ability to use analytical and visualization tools such as Excel (including advanced data manipulation techniques) and Power BI.</li>
<li>Interest in public health or issues relevant to health services research, MCH, and health program or policy evaluation.</li>
<li>Ability to plan for and work on multiple projects concurrently.</li>
<li>Ability to exercise sound judgment in making decisions and maintain thorough documentation of the decision-making process.</li>
<li>Exemplary communication skills and ability to communicate effectively, both verbally and in writing, complicated processes to diverse audiences.</li>
<li>Strong commitment to rigorous research methods, objectivity, accuracy of findings, and reproducibility of results.</li>
</ul></div><br>
</div></div></div><div><div>Job Duties
</div><p></p><div><div><div><div><b>Job Duty</b></div>
<div><div>Actively contributes to the review of working practices and developing data analysis and management standard operating procedures, including developing rigorous documentation of methods, decisions, flowcharts, and other practices that ensure reproducibility of results.</div><div>
(15%) Analyzes and interprets complex healthcare data.</div></div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>15</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Analyzes and interprets complex healthcare data from various sources; identifies, analyzes, and interprets trends and patterns in complex datasets to understand MCH issues.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>15</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Obtains, validates, and compiles data from multiple sources to create summary files for both external and internal use.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>10</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Manages large databases of health insurance claims from Medicaid, Medicare, all-payer data warehouses, and other state administrative datasets, as well as EHR data.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>10</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Creates clear reports that demonstrate analytic findings and present these to the management and relevant stakeholders; Ensures accuracy and timeliness of reports, including regularly scheduled and ad-hoc reporting requests. Responsible for all follow-up and/or research requests regarding clinical data.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>15</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Coordinates and problem-solves with Institute faculty/staff to understand needed support and use cases and develops innovative solutions to fill gaps in analytics.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>15</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Works independently under the direction of the Principal Investigators to design, manage, implement, and interpret statistical analyses focused on MCH-related healthcare expenditures, utilization, and quality.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>15</div>
</div><br>
</div></div><div><div><div><div><b>Job Duty</b></div>
<div>Performs other research related duties as assigned.</div>
</div><br>
<div><div><b>Essential Function</b></div> <div>Yes</div>
</div><br>
<div><div><b>Percentage of Time</b></div> <div>5</div>
</div><br>
</div></div></div><div><div>Position Attributes
</div><p></p><div><div><div><div><b>Hazardous weather category</b></div> <div>Non-Essential</div>
</div><br>
<div><div><b>Employees in Safety-Sensitive or Security-Sensitive positions will be subject to pre-employment and post-employment drug testing in accordance with University policy HR 1.95 Drug and Alcohol Testing.</b></div> <div>No</div>
</div><br>
</div></div></div><div><div>Posting Detail Information
</div><p></p><div><div><div><div><b>Number of Vacancies</b></div> <div>1</div>
</div><br>
<div><div><b>Desired Start Date</b></div> <div>05/01/2026</div>
</div><br>
<div><div><b>Position End Date </b></div><div>06/30/2028</div>
</div><br>
<div><div><b>Job Open Date</b></div> <div>03/11/2026</div>
</div><br>
<div><div><b>Job Close Date</b></div> <div>04/24/2026</div>
</div><br>
<div><div><b>Open Until Filled</b></div> <div>No</div>
</div><br>
<div><div><b>Special Instructions to Applicant</b></div>
<div><div>Positions are advertised for a minimum of five (5) business days on our job website. After five (5) business days, positions can be closed at the discretion of the department at any time. This employment site is updated on a regular basis. The length of the recruitment and screening process may vary from position to position, depending upon a variety of factors. Should review of your qualifications result in a decision to pursue your candidacy, you will be contacted by phone or email.</div><div>
We are only accepting applications submitted by April 24, 2026.</div></div>
</div><br>
<div><div><b>Quicklink for Posting</b></div> <div>https://uscjobs.sc.edu/postings/203310</div>
</div><br>
<div><div><b>EEO Statement</b></div>
<div>The University of South Carolina does not discriminate in educational or employment opportunities or decisions for qualified persons on the basis of age, ancestry, citizenship status, color, disability, ethnicity, familial status, gender (including transgender), gender identity or expression, genetic information, HIV/AIDs status, military status, national origin, pregnancy (false pregnancy, termination of pregnancy, childbirth, recovery therefrom or related medical conditions, breastfeeding), race, religion (including religious dress and grooming practices), sex, sexual orientation, veteran status, or any other bases under federal, state, local law, or regulations.</div></div></div></div></div></div></div></div><p></p>

MCH Health Care Data Analyst

Vheda Health

<div><p><b>Important Notice</b><b>: </b>Please be aware of recruiting scams &mdash; Vheda Health will <b>never ask</b><b> </b>for sensitive, personal information or payment information during the hiring process. Further, Vheda Health will only contact eligible candidates (who apply for an eligible role) from our domain &mdash; vheda.com. All active career postings can be found at www.vheda.com/careers.</p><p></p><p><b><br>
About Vheda Health</b></p><p>
Vheda Health is a leader in virtual health engagement, dedicated to improving health equity for underserved populations. With over 10 years of experience and a strong national presence, our turnkey chronic care programs provide simple access to care from anywhere, helping health plans deliver better outcomes for their members.</p><p><b><br>
About Vheda Health</b></p><p>
Vheda Health is a leader in virtual health engagement, dedicated to improving health equity for underserved populations. With over 10 years of experience and a strong national presence, our turnkey chronic care coordination programs provide simple access to care coordination from anywhere, helping health plans deliver better outcomes for their members.</p><p></p><p><b><br>
Position Overview</b></p><p>
We're seeking a talented and motivated<b> Healthcare Medical Economics Analyst</b> to join our team. The Healthcare Medical Economics Analyst plays a critical role in evaluating healthcare program performance, financial risk, and clinical outcomes through advanced analytical and statistical techniques. This role applies medical economics, biostatistics, and data science methodologies to generate actionable insights that support decision-making across clinical, client services, and leadership teams. The analyst will translate complex data into clear, data-driven recommendations and partner cross-functionally to support population health, utilization management, and value-based care initiatives.</p><p></p><p><b><br>
Key Responsibilities</b></p><ul><li>Apply principles of medical economics, statistics, and quantitative analysis to evaluate financial risk, utilization patterns, and program impact.</li><li>Conduct control group analyses and implement propensity score matching to assess intervention effectiveness.</li><li>Perform statistical significance testing to validate intervention outcomes.</li><li>Utilize analytical techniques such as correlation and regression analysis to identify trends and drivers.</li><li>Summarize and interpret key statistical metrics and provide actionable recommendations.</li><li>Translate business questions into analytical frameworks and decision-support tools.</li><li>Serve as a subject matter expert in statistical analysis and interpretation.</li><li>Supports and Works with data scientist to finalize results</li></ul><p></p><p><b><br>
Data Management &amp; Technical Expertise</b></p><ul><li>Manipulate, clean, and transform large and complex datasets; identify and resolve data quality issues.</li><li>Maintain strong understanding of data warehouse structures, data definitions, and data integrity.</li><li>Understand operational processes and supporting platforms to ensure accurate analysis.</li><li>Demonstrate strong analytical, organizational, and problem-solving skills.</li><li>Utilize SQL, R , Python and advanced Excel for analysis; PowerPoint for executive presentations.</li></ul><p></p><p><b><br>
Reporting, Insights &amp; Storytelling</b></p><ul><li>Draft clear written summaries of analytical findings.</li><li>Present results using tables, charts, and visualizations.</li><li>Create and maintain recurring and ad hoc reports.</li><li>Provide data-driven recommendations aligned with business and clinical objectives.</li></ul><p></p><p><b><br>
Collaboration &amp; Business Partnership</b></p><ul><li>Partner with Client Services to deliver insights for internal and external stakeholders.</li><li>Collaborate with clinical teams to develop member insights, risk scores, and compliance metrics.</li><li>Support device management and digital health initiatives through utilization and outcomes analysis.</li></ul><p><b>
Required Qualifications</b></p><ul><li> Bachelor&rsquo;s degree in Statistics, Mathematics, Public Health, Data Science, or related field (Master&rsquo;s preferred).</li><li> Experience in healthcare analytics, medical economics, or population health.</li><li> Strong communication skills with the ability to translate complex data into business insights.</li><li> Experience with healthcare claims, eligibility, utilization, or clinical data preferred.</li><li> Experience in the device management or digital health industry is a plus.</li></ul><p></p><p><b><br>
Preferred Qualifications</b></p><p></p><p><b><br>
Why Join Vheda Health?</b></p><p>
At Vheda Health, we invest in our team's wellbeing with a comprehensive benefits package:</p><ul><li> <b>Compensation:</b> Competitive salary within the published range plus performance bonus and equity opportunities</li><li> <b>Healthcare: </b>Comprehensive medical, dental, and vision coverage</li><li> <b>Financial Security:</b> 401(k) retirement plan, voluntary life insurance, short and long-term disability</li><li> <b>Work-Life Balance:</b> Unlimited paid time off and 12 paid company holidays</li><li> <b>Community:</b> Engaging team events and activities throughout the year</li></ul><p></p><p><br>
Base salary range: Up to $120,000 per year based on experience, location, and education.</p><p></p><b><br>
The pay range for this role is:</b><br>
65,000 - 120,000 USD per year(Remote)</div>

Healthcare Medical Economics Analyst

Lifepoint Health

<div><div><b>Schedule: Days: M-F</b></div><div><b>
Job Location Type: Remote</b></div><div></div><div><b><br>
Your experience matters</b></div><div>
At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Health Support Center (HSC) team, you&rsquo;ll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of <i>making communities healthier</i><i> &reg;</i>.</div><div></div><div><b><br>
More about our team</b></div><div>
As <b>a Financial Analyst, Physician Services</b> you will assist with tasks related to analytics and decision support by gathering and reporting financial and operational trends and results to submit for actionable insights. This role supports the AVP Finance, Medical Group Services with critical thinking projects and is expected to self-guide their routine work after instruction. The right individual will be open to change, suggest ideas for process improvement, and have a positive attitude and enthusiastic approach to problem-solving.</div><div></div><div><b><br>
How you&rsquo;ll contribute</b></div><div>
A Financial Analyst, Physician Services who excels in this role:</div><ul><li><div>
Provide direct support to the MGS Finance team, in meeting the strategic and operational goals of MGS primarily through meaningful, accurate, and timely financial reporting.</div></li><li><div>
Collaborate with MGS leadership to report the financial impact of operations, identify key operational drivers, and create Monthly Operating Reports (MORs).</div></li><li><div>
Utilize various Business Intelligence (BI) tools to gather, manipulate, and analyze data to pro-duce regular monthly reports and ad hoc analyses.</div></li><li><div>
Organize, review data, analyze reporting information and seek out trends for leaders to re-view.</div></li><li><div>
Perform work in a timely manner, with accuracy.</div></li><li><div>
Support the finance team to provide new reports and methodologies to drive operational improvement and meet MGS strategic goals.</div></li><li><div>
Coordinate with clinic finance and operations teams to ensure provider-level reporting is user friendly, real time and prompt.</div></li><li><div>
Support the annual budget preparation process.</div></li><li><div>
Develop and obtain new BI technical skills.</div></li></ul><div></div><div><b><br>
Why join us</b></div><div>
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:</div><ul><li><div><b>
Comprehensive Benefits</b>: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.</div></li><li><div><b>
Financial Protection &amp; PTO</b>: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.</div></li><li><div><b>
Financial &amp; Career Growth</b>: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.</div></li><li><div><b>
Employee Well-being</b>: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).</div></li><li><div><b>
Professional Development</b>: Ongoing learning and career advancement opportunities.</div></li></ul><div></div><div><b><br>
What we&rsquo;re looking for</b></div><ul><li><div><b>
EDUCATION:</b> This position requires a Bachelor&rsquo;s Degree required (Accounting, Business, Mathematics, Finance, Information Systems, or other quantitative field of study)</div></li><li><div><b>
EXPERIENCE:</b> 0-2 years of experience in healthcare finance preferred</div></li></ul><div></div><div><b><br>
EEOC Statement</b></div><div>
&ldquo;Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.&rdquo;</div><div></div><div><br>
You must be authorized to work in the United States without employer sponsorship.</div><br>
<div></div>
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.</div>

Financial Analyst, Physician Services

Network Solutions IPA

<p><b>Healthcare Financial Analyst</b></p><p><b>Work Setting: </b>Hybrid (Remote + On-site)</p><p><b>Work Location: </b>3611 14th Ave, Brooklyn, 11218</p><p><b>About NSIPA:</b></p><p>Network Solutions IPA (NSIPA) is a leading New York&ndash;based Independent Practice Association with a diverse, multi-specialty provider network. The organization has grown to more than <b>600 physician members</b>, serving over <b>100,000 patients</b> across New York City, Nassau, Suffolk, and Westchester counties.</p><p>We are committed to helping independent providers succeed in the transition to value-based care.​</p><p>Through strategic partnerships, operational support, and robust payer relationships, NSIPA delivers the tools, resources, and expertise that allow practices to grow, perform, and succeed in today&rsquo;s complex healthcare landscape without sacrificing independence. ​ We achieve this by collaborating with payers to deliver Quality Incentive Programs, Shared Savings arrangements, and Risk-Based Contracts. Contracted with over 21+ Payers for over 600+ Providers.</p><p>NSIPA provides a comprehensive suite of services, including credentialing and network operations, provider engagement, and contracting; care coordination and member outreach; and provider-and patient centered programs. As part of New York State&rsquo;s 1115 Medicaid Waiver, NSIPA plays a key role in identifying, screening, and addressing health-related social needs by connecting Medicaid members to community-based resources and care supports. These services are designed to strengthen provider efficiency, address health related social care needs, and advance value‑based care and population health opportunities. Recognized as one of New York&rsquo;s fastest‑growing IPAs, NSIPA supports improved clinical outcomes, enhanced provider performance, and cost savings for payers through its robust infrastructure and operational expertise.</p><p><b>Position Overview: </b></p><p>We are seeking a detail-oriented Financial Analyst with 1&ndash;2 years of experience in reconciliations and financial reporting to support our Value-Based Care (VBC) initiatives. This role will assist in analyzing financial performance, validating payment data, and ensuring accuracy in reconciliations related to payer contracts and population health programs.</p><p>The ideal candidate is analytical, organized, and comfortable working with financial data in a healthcare environment.</p><p><b>Roles &amp; Responsibilities:</b></p><p>&middot; Perform monthly and quarterly financial reconciliations related to VBC contracts and payer arrangements including but not limited to medical expense ratio, premium, IBNR and quality dependency components.</p><p>&middot; Assist in validating capitation payments, shared savings calculations, and incentive payments.</p><p>&middot; Understanding managed care, Medicare and Medicaid value-based care models and their calculations.</p><p>&middot; Prepare recurring financial and operational reports for leadership review.</p><p>&middot; Analyze variances and identify discrepancies in payment and claims data.</p><p>&middot; Support forecasting and budgeting activities for VBC programs.</p><p>&middot; Collaborate with operations, billing, and population health teams to ensure data accuracy.</p><p>&middot; Maintain financial tracking models and update performance dashboards.</p><p>&middot; Assist with audit preparation and documentation as needed.</p><p>&middot; Assist with managing care gap files and the submission and oversight of supplemental data files.</p><p>&middot; Ensure compliance with internal financial controls and reporting standards.</p><p><b>Skills &amp; Competencies:</b></p><p>&middot; Proficiency in Microsoft Excel (formulas, pivot tables, VLOOKUP, data analysis)</p><p>&middot; Ability to identify trends, variances, and anomalies in financial reports</p><p>&middot; Strong analytical, financial and problem-solving skills</p><p>&middot; Excellent attention to detail and accuracy in financial data</p><p>&middot; Ability to work independently and as part of a team</p><p>&middot; Comfortable working with large datasets and performing reconciliations</p><p><b>Required Qualifications:</b></p><p>&middot; 1&ndash;2 years of experience in financial analysis, reporting, or reconciliations</p><p>&middot; Knowledge of basic accounting principles and financial controls</p><p>&middot; Familiarity with healthcare finance, Value-Based Care (VBC), or preferred payer contracts</p><p>&middot; Understanding of healthcare payment models (capitation, shared savings, bundled payments) is a plus</p><p>&middot; Strong organizational and time-management skills with the ability to prioritize tasks</p><p><b>Why Join NSIPA?</b></p><p>&middot; High-impact leadership role with direct influence on organizational strategy.</p><p>&middot; Opportunity to shape the future of value-based care across diverse populations.</p><p>&middot; Collaborative, mission-driven environment focused on improving patient outcomes.</p><p>&middot; Visibility, growth, and the ability to build and scale performance programs.</p><p><b>Physical Demands:</b></p><p>The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel; make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or utilize computer equipment; reach with hands and arms; and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, ability to adjust focus and ability to match or detect differences between colors, including shades of color and brightness.</p><p><b>EEO Statement:</b></p><p>NSIPA is an equal opportunity employer committed to diversity and inclusion. We encourage applications from all qualified individuals regardless of race, color, religion, gender, sexual orientation, age, national origin, disability, or veteran status.</p><p>Pay: $25.00 - $27.00 per hour</p><p>Work Location: Hybrid remote in Brooklyn, NY 11218</p>

Healthcare Finance Analyst

Apogee Solutions, Inc.

<div><p>For Talented, Motivated Individuals Who Want To Become Part Of A Growing Company And A Winning Team.</p>
<p><b>
Our Employees Work Across The Country.</b></p>
<p><b>
 </b>As a leader in delivering innovative solutions for our nation&rsquo;s highest-priority defense and homeland security initiatives, we provide talented individuals with the opportunity to:</p>
<ul>
<li>Work with the latest tools and technologies</li>
<li>Perform important work that contributes to the well-being of the nation</li>
<li>Join an organization that values people and teamwork, and offers career growth and training</li>
</ul>
<p>We offer our employees a competitive compensation, vacation, and benefits package, including a Safe Harbor company match 401(k), as well as a fast-paced and exciting work environment with nationwide opportunities.
<br>
<br>
Our ongoing commitment to the Military Spouse Employment Partnership and Women in Defense demonstrates our ongoing emphasis as a Woman-Owned Small Business.<br>
<br>
<b>Apogee Solutions is an Equal Opportunity and Affirmative Action Employer. We welcome and encourage diversity in our workforce.</b></p>
<p>Apogee Solutions, a woman-owned small business, is seeking a Healthcare Business Analyst in the National Capital Region to support the National Intrepid Center of Excellence (NICoE), which is a state-of-the-art institute that provides clinical research informed care, intensive outpatient evaluation, advanced diagnostics, comprehensive treatment plans, treatment modalities, and long-term follow-up for patients suffering from Traumatic Brain Injury (TBI) and Psychological Health (PH) issues. Using cutting edge evidence-based practice, technology and research tools, the NICoE facilitates maximum recovery for warriors and families, and return to function within their home communities. The NICoE&rsquo;s mission is to improve the lives of patients and families impacted by TBI through excellence and innovation.</p>
<p>
The Directorate for NICoE at Watler Reed National Military Medical Center (WRNMMC) has the shared responsibility with other Directorates at WRNMMC for the assessment, treatment, and rehabilitation of those with traumatic brain injury and associated psychological health conditions. Often, the NICoE serves patients that have failed other more traditional treatments; therefore, a multitude of novel approaches need to be available to enhance the diagnostic and therapeutic approaches to meet the complex challenges experienced by this unique patient population. This includes providing individualized, holistic care in a safe and effective manner.</p>
<p>
The Healthcare Business Analyst shall provide business and data analysis in support of NICoE clinical operations to improve workflows, system integration, and healthcare delivery.</p>
<p>
Responsibilities:</p>
<ul>
<li>Support government informatics staff in defining detailed business and data requirements that strengthen NICoE&rsquo;s clinical operations.</li>
<li>Document productivity measures, system requirements, and change requests to ensure alignment with clinical workflows.</li>
<li>Contribute to integration and implementation plans that improve healthcare delivery and operational efficiency.</li>
<li>Assist with procedure and policy creation, process improvement, and monitoring for clinical business processes.</li>
<li>Assist staff with administrative needs.</li>
<li>Provide meeting support for clinical business reviews and manage conference room assignments for healthcare operations activities.</li>
<li>Prepare business and data requirements document developed system requirements reports, clinical process improvements projects, drafted integration and implementation plans, maintained policy documentation, and provided meeting support records.</li>
</ul>
<p>Requirements:</p>
<ul>
<li>US Citizen with the ability to pass a background check, to include Federal Bureau of Investigation (FBI) fingerprint check and National Agency Check with Written Inquires (NACI)</li>
<li>Active, adjudicated Tier 1 background investigation preferred</li>
<li>Bachelor's degree from an accredited university</li>
<li>Demonstrated ability to operate effectively within fast-paced, mission-driven settings while maintaining accuracy, discretion, and compliance with applicable policies and regulations</li>
<li>Possess strong business acumen and professional judgment, with demonstrated proficiency in Microsoft Office 365 applications, including but not limited to Outlook, Word, Excel, PowerPoint, Teams, and SharePoint</li>
<li>Experience with electronic health record (EHR) systems with MHS-Genesis is preferred</li>
<li>Familiarity with clinical documentation workflows, data entry standards, and health information management processes will be considered a significant strength</li>
<li>Must have a strong attention to detail and be highly organized</li>
</ul><b>Apogee Solutions is an Equal Opportunity and Affirmative Action Employer. We welcome and encourage diversity in our workforce.</b><br>
<br>
Apogee Solutions provides equal employment opportunity to all employees and qualified applicants without regard to race, color, religion, national origin, sex, age, disability, pregnancy, sexual orientation, gender identity, genetic information, protected veteran status, or any other protected characteristic under federal, state or local laws.<br>
<br>
Apogee Solutions proudly supports a culture of inclusion that encourages a work environment that honors diverse opinions. Employees can flourish here: they know their individual skills, abilities and viewpoints are honored. Our diverse business is united by a common goal of being the best in the business, delivering value, and being a good corporate citizen in each of the communities where we do business</div>

Healthcare Business Analyst

Machinify

<div><div><p>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 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We&rsquo;re constantly reimagining what&rsquo;s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.</p></div><div><p>
We&rsquo;re seeking a skilled <b>Senior Data Analyst </b>to join our team!</p>
<p>
Join our Data Engineering team and help transform complex healthcare claims data into powerful insights that shape business strategy, drive clinical decisions, and support ML and analytics initiatives. You&rsquo;ll architect data mappings, ensure data integrity, and serve as the go-to expert on claims data&mdash;bridging the gap between raw data and actionable outcomes.</p>
<p>
Does this sound like the right opportunity to explore?... Let's connect!
</p><p><b>What You&rsquo;ll Do</b></p>
<ul>
<li>Design and maintain robust data transformations and mappings to convert raw medical claims into standardized canonical models.
</li><li>Perform detailed data quality audits to detect, troubleshoot, and resolve issues impacting accuracy and completeness.
</li><li>Write and optimize Spark SQL queries to validate data pipelines and support ongoing analytics.
</li><li>Document data transformation logic and lineage to ensure transparency and reusability.
</li><li>Collaborate cross-functionally with business stakeholders to translate data needs into technical specs.
</li><li>Support onboarding of new client data feeds, ensuring smooth integration with minimal disruption.
</li><li>Partner with data engineers to build and scale data pipelines, improving performance and reliability.
</li><li>Act as a subject matter expert for healthcare claims data&mdash;advising on risk, trends, and business impact.
</li><li>Work closely with data scientists to enable advanced analytics, ML models, and reporting use cases.
</li><li>Troubleshoot ETL workflows and performance issues, driving continuous improvement in data architecture.</li>
</ul>
<p><b>What You Bring</b></p>
<ul>
<li>Bachelor&rsquo;s degree in Business, Computer Science, Health Informatics, or a related field.
</li><li>6+ years of experience as a data analyst or business analyst working with large datasets.
</li><li>6+ years of hands-on experience with healthcare claims data (e.g., 837 EDI, medical billing, encounterdata).
</li><li>Advanced proficiency in SQL and familiarity working with Spark or similar big data framework will be bonus.
</li><li>Solid understanding of data modeling concepts and best practices for analytics. \</li>
<li>Proven problem-solving skills and attention to detail in complex data environments.
</li><li>Strong organizational skills and ability to manage multiple concurrent initiatives.
</li><li>Excellent written and verbal communication skills, especially when explaining technical concepts to non-technical stakeholders (e.g., clinicians, account managers, data scientists).
</li><li>Self-starter with a strong sense of ownership and accountability</li>
</ul>
<p><b>What We Offer</b></p>
<ul>
<li>Work from anywhere in the US! Machinify is digital-first.</li>
<li>Full Medical/Dental/Vision for employees &amp; their families</li>
<li>Flexible and trusting environment where you&rsquo;ll feel empowered to do your best work</li>
<li>Unlimited FTO</li>
<li>Competitive salary, equity, 401(k) including employer match</li>
</ul>
<p>The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. The base salary range for this role is $140k-$170k. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.</p></div><div><div><b>
Equal Employment Opportunity at Machinify</b></div>
<div></div>
<div>We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/</div></div></div>

Healthcare Data Analyst

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