Quality Control Data Analyst

Quality Control Data Analyst I

The Quality Control Data Analyst I will support quality control and assurance activities for all data products and processes using data from the Colorado All Payer Claims Database (CO APCD) and other sources. This position supports the Data Solutions' teams by providing timely reviews, comparisons, and output validations of CIVHC's data products. This position supports CIVHC in ensuring that CO APCD data and data products are complete, accurate, and reliable in support of a variety of existing and novel use cases.

The Quality Control Analyst I helps identify opportunities to develop and enhance quality control standards to better serve CIVHC teams and partners. Under the supervision of the Quality Control Manager, the Analyst will leverage existing technical and analytic skills to complete assigned project reviews while strengthening foundational understanding of health care claims data. Success in this role will be measured according to the accuracy, completeness, and usability of CIVHC administered data.

This position is based in Denver, Colorado. Because CIVHC operates under a hybrid work model with a requirement of at least one in-office day per week (unless otherwise approved), candidates must reside within a commutable distance to the Denver metro area. Limited relocation assistance may be available for out-of-state candidates who intend to relocate to the Denver area.

Responsibilities for this position may include, but are not limited to:

• Serves as a primary reviewer of custom data set and report products prior to delivery to external and internal partners.
• Leverages basic SQL skills to perform validation checks, compare output to established benchmarks, and other similar activities to support the integrity of the final output.
• Follows guidance to understand issue resolution and implements needed adjustments for future work.
• Understands and executes assigned functions and tasks, proactively requesting support as needed.
• Works from instructions within established frameworks and team structures.
• Performs project-level analyses and support larger analytic initiatives as assigned by the Quality Control Manager.
• Prepares for and participates actively in internal meetings, and may attend external meetings as appropriate to support project work.
• Listens, asks clarifying questions, and owns assigned tasks while delivering work products within established timelines.
• Shares findings and insights clearly in both written and verbal communications.

Required Skills/Abilities:

• Proficiency in SQL basics (understanding of SELECT, FROM, WHERE, ORDER BY statement); interest and experience in one additional programming language (R, Python, or similar) preferred
• Exposure to data visualization tools and use (e.g., Power BI, Tableau, etc.)
• Basic understanding of healthcare procedure and/or diagnosis codes and standards, or desire/willingness to learn
• Basic understanding of healthcare systems and/or data; willing to learn HIPAA, HL7, PHI, and healthcare standards
• Desire to independently investigate findings, analyze output, or improve upon established quality checks.
• Ability to communicate analytic findings to both technical and non-technical audiences, with support from the Quality Control Manager.
• Good organizational skills to independently manage assigned tasks within established deadlines.
• Collaborative work style, actively seeking out input or guidance from others through asking clarifying questions, actively listening, etc.
• Desire to build skills and knowledge related to healthcare data analytics, systems, and structures.
• Strong attention to detail.
• Demonstrated ability to manage multiple data-focused projects simultaneously
• Strong critical thinking and problem-solving skills, with the ability to make recommendations aligned with customer needs
• Excellent interpersonal and customer service skills
• Strong communication and organizational skills, with the ability to collaborate effectively across teams
• Excellent time management skills and ability to meet deadlines
• Experience with project planning/project management software
• Exceptional attention to detail
• Ability to develop and execute long-term work plans with multiple partners and overlapping deadlines
• Creativity, tenacity, diligence, and curiosity

Education & Experience:

• Bachelor's degree in healthcare informatics, data science, computer science, or related field
• Alternative: 5+ years of claims data analysis experience can substitute for a degree
• Experience in a health plan or managed care environment, focusing on claims, member, and provider data, decision support, or performance measurement, gained through internships, academic projects, or professional employment is welcomed
• Experience analyzing commercial, Medicare, and/or Medicaid claims and/or claim billing and processing preferred
• Experience working with big data, preferably in an enterprise data warehouse environment
• Demonstrated ability to run queries using basic SQL commands Must demonstrate strong critical…