Analysis & Efficiencies Senior Analyst

Overview

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers;
Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans; and Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit (Use the "Apply for this Job" box below)..

The Government Programs Analysis & Efficiencies Senior Analyst will play a pivotal role in supporting the operational success of Medicare, Medicaid, and the Exchange programs. This analyst develops data-driven solutions that enhance efficiency and reduce manual efforts. Under the guidance of the Operations Manager, this analyst utilizes complex datasets to identify actionable insights that inform strategic decisions and drive ongoing improvement.

The analyst’s responsibilities encompass delivering recurring and ad-hoc reports, designing and leading the implementation of BI dashboards, and creating standardized code templates to automate deliverables. Additionally, the analyst contributes to process optimization by designing scalable, automated solutions that streamline workflows and minimize manual intervention. Collaboration with cross-functional teams, including compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations, is crucial to ensure that analytical tools and operational capabilities align with both regulatory requirements and business objectives.

• Analyze complex datasets to identify trends, outliers, and opportunities for operational improvement across Medicare, Medicaid, and Exchange programs
• Develop and maintain recurring and ad-hoc reports, dashboards, and analytical tools to support data-driven decision-making
• Create and maintain a repository of standardized code templates to streamline report generation and automate routine tasks
• Ensure analytical outputs align with regulatory requirements and business objectives by interpreting CMS and state guidance in partnership with internal subject matter experts
• Support the development of scalable processes that enhance efficiency, accuracy, and responsiveness across government program operations
• Design and implement automated solutions to reduce manual effort and improve process scalability and accuracy
• Implements and uses analytical software to support the department in achieving goals as defined by executive leadership
• Facilitate requirements gathering sessions to understand business needs and translate them into actionable analytical deliverables
• Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met
• Presents and communicates complex analytical findings in a clear and concise manner
• Participates in user acceptance, and quality assurance testing of new application features and team deliverables
• Supports root-cause-analysis and reporting of encounter data issues/errors by partnering with key stakeholders – will also provide operational support
• Prepares high-level user documentation and training materials as needed
• Work with internal and external clients to research, develop, and document new standards to enhance reporting capabilities
• Collaborate with cross-functional teams—including compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations—to refine and enhance operational capabilities
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance

• 4+ years of healthcare data experience
• 4+ years of experience working with SQL, R, or Python
• 4+ years of experience working with business intelligence tools
• Experience…