Government Programs Claims Analyst - Metrics and Monitoring

Government Programs Claims Analyst – Metrics and Monitoring

Number of Positions: 1
•

Location:

Okemos, MI
• Position Type:
Hybrid

Job Summary:

At Delta Dental of Michigan, Ohio, and Indiana, we work to improve oral health through benefit plans, advocacy, and community support. We are one of the largest dental plan administrators in the country, operating within the Delta Dental Plans Association.

• Develop, maintain, and enhance dashboards and reports using Power BI, Tableau, or similar data visualization tools to monitor claims performance and operational metrics.
• Analyze claims data to identify trends, anomalies, root causes, and performance gaps related to timeliness, accuracy, cost, utilization, and compliance.
• Monitor key performance indicators and service level agreements for claims operations, escalating risks and issues as appropriate.
• Collaborate and communicate closely across departments to ensure reporting data accuracy and consistency.
• Support internal and external reporting requirements, including new client implementations and account management support.
• Ensure data integrity, accuracy, and consistency across reports and dashboards.
• Automate recurring reports and improve reporting efficiency where possible.
• Contribute to continuous improvement initiatives related to claims processing and data analytics.
• Run basic SQL queries and work with Government Programs Reporting for more complex queries.
• Perform other related duties as necessary to complete the primary responsibilities.

• Bachelor’s degree in health administration, business, data analytics, finance, or a related field and three years of experience analyzing or resolving business, system, or process issues within the healthcare or insurance industry.
• Preferred:
  Experience in the administration of Medicare and/or Medicaid programs.
• Experience with data visualization tools (Power BI and/or Tableau), SQL or similar querying tools, and proficiency in Excel with large datasets.
• Strong analytical skills and attention to detail with a focus on data accuracy.
• Ability to work independently and as part of a team, managing multiple assignments with competing deadlines.
• Effective verbal and written communication skills.
• Ability to resolve complex problems using independent judgment.

Delta Dental of Michigan, Ohio, and Indiana provides equal employment and advancement opportunities within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

Delta Dental is an Equal Opportunity Employer.