Data Analyst (Healthcare)

About The Company Providence Health Plan is a leading healthcare organization dedicated to providing comprehensive, patient-centered care across multiple states. With a rich history spanning over a century, Providence is committed to serving the community by delivering high-quality health services that prioritize the well-being of every individual. The organization values diversity, inclusion, and innovation, fostering a collaborative environment where caregivers and staff are empowered to make a meaningful difference in patients’ lives. Providence’s mission is rooted in compassion, respect, and a deep commitment to addressing the unique needs of the communities it serves, including vulnerable populations. As part of a larger family of healthcare providers, Providence continuously strives to improve health outcomes, advance medical practices, and promote health equity through innovative programs and dedicated professionals.

About The Role The Risk Adjustment Analytics Principal at Providence Health Plan serves as a critical technical expert and strategic partner within the organization. This role involves working closely with the Risk Adjustment department and the Data Analytics team to develop and implement tools, metrics, and reports that support the organization’s risk management and financial performance strategies. The Principal is responsible for leading complex data analysis projects, designing evaluation plans, and ensuring data integrity across various sources. This position requires advanced analytical skills, project management expertise, and a thorough understanding of healthcare risk adjustment regulations and methodologies. The role also entails mentoring junior staff and analysts, fostering a culture of continuous improvement and technical excellence. The Principal acts as a liaison across departments, including Actuarial, Compliance, Finance, IS, and external agencies, building strong relationships to align analytics initiatives with organizational goals. Maintaining current knowledge of healthcare trends, risk adjustment regulations, and analytic techniques is essential to ensure the organization remains compliant and competitive in the evolving healthcare landscape.

Qualifications

• Bachelor’s Degree in Statistics, Mathematics, Actuarial Science, Economics, Engineering/Physics, Accounting, Computer Science, or a related highly quantitative field.
• Minimum of 10 years of experience in data analysis at a decision-making level, or High School Education with at least 12 years of relevant experience.
• Proven experience in healthcare data analysis, risk adjustment, or related fields.
• Strong project management skills with the ability to lead complex initiatives.
• Excellent communication skills to effectively collaborate with cross-functional teams and external agencies.
• Deep understanding of healthcare risk adjustment processes, models, and regulations.
• Experience with advanced analytics, reporting tools, and data visualization techniques.
• Preferred: Master’s Degree in a related field and formal training in CQI/TQM and statistical process control methodologies.
• Healthcare organization or health insurer experience is highly desirable.

Responsibilities

• Collaborate with Risk Adjustment leadership and stakeholders to establish analytics priorities, define project scope, and ensure timely delivery of reports and tools.
• Develop and maintain advanced analytical models and reports to support risk adjustment strategies and performance measurement.
• Lead data collection, validation, and analysis efforts across multiple systems and sources to ensure accuracy and completeness.
• Provide expert guidance on risk adjustment methodologies, expected outcomes, and regulatory requirements.
• Organize and present complex data analyses to senior leadership, translating technical findings into actionable insights.
• Mentor and develop junior analysts and team members, fostering a culture of continuous learning and technical excellence.
• Build and maintain relationships with internal departments such as Actuarial, Compliance, Finance, and IS, as well as external agencies like CMS and state regulators.
• Stay current on healthcare industry trends, regulatory changes, and emerging analytics techniques to ensure organizational compliance and competitiveness.
• Participate in strategic planning and contribute to the ongoing development of risk adjustment initiatives and analytics capabilities.

Benefits

• Comprehensive health care benefits including medical, dental, and vision coverage.
• Retirement savings plan with employer matching contributions.
• Paid time off, including vacation, holidays, and parental leave.
• Disability and life insurance coverage.
• Well-being resources and employee assistance programs.
• Ongoing professional development and training opportunities.
• Flexible remote work options for eligible states.

Equal Opportunity

Providence Health Plan is an equal opportunity employer committed to fostering an inclusive and diverse workforce. We do not discriminate based on race, color, gender, disability, veteran status, religion, age, sexual orientation, gender identity, marital status, genetic information, or any other protected characteristic. We believe diversity strengthens our organization and are dedicated to creating a work environment where everyone is valued, respected, and has equal opportunities for growth and advancement.