Solutions and Data Analyst III

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Job Category:
Administrative, HR, Business Professionals

Location:

Los Angeles, CA, US, 90017

Position Type:
Full Time

Requisition

Salary Range: $ (Min.) – $ (Mid.) – $ (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Solutions and Data Analyst III serves as a Subject Matter Expert (SME), technical and analytic integrator, responsible for designing, developing, and operationalizing advanced analytic solutions that drive strategic insight and organizational performance. This position combines strong data engineering fluency with analytical acumen transforming complex, multi-domain data (membership, encounters, providers, claims, quality metrics) into interpretable and actionable insights used by leaders across the health plan.

This position emphasizes the development of insight rich, production ready analytic assets, delivering repeatable, governed analyses that illuminate key drivers of care quality, efficiency, and financial outcomes. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.

• Designs and maintains reusable analytic data models and Extract, Transform, and Load (ETL) pipelines that support recurring insight generation and performance monitoring.
• Leads development of advanced dashboards, reports, and analytic tools that surface trends, correlations, and performance opportunities across enterprise domains.
• Partners with analysts, data scientists, and operational stakeholders to embed insights directly into workflows and decision processes.
• Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.
• Ensures adherence to data lineage, governance, and reproducibility standards across all analytic products.
• Supports enterprise level measure refresh cycles and ensures alignment with standardized data abstraction layers.
• Drives continuous enhancement of the analytic ecosystem by integrating new data sources, improving data structures, and optimizing performance.
• Translates analytic findings into business-relevant narratives and partners with stakeholders to act on insights.
• Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation’s policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc.
  
  as needed.
• Performs other duties as assigned.

Domain Focus:
Authorization & Claims Operations Analytics

Required: Experience with Utilization Management (UM) authorization workflows and prior authorization metrics. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution.

Required: Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational KPIs (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.

Required: Experience supporting initiatives to optimize cost, access, and quality within provider networks. Experience analyzing provider networks, including contracting, credentialing, and panel optimization. Ability to evaluate network performance metrics and translate…