Senior Data Analyst - II

About Us

Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

Why We Do What We Do

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

Act as a data liaison, providing actionable insights and guiding the integration of diverse data sources. Perform in-depth analyses of provider data, implement data quality assurance processes, and support provider services using existing data stores.

About Zelis

• Zelis is a leading payments company in healthcare, guiding, pricing, explaining, and paying for care on behalf of insurers and their members.
• We align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all.
• Partnering with 700+ payers, supporting 4 million+ providers and 100 million members across the healthcare industry.
  
  

About ZDI

Zelis Data Intelligence (ZDI) is a centralized data team that partners across Zelis business units to unlock the value of data through intelligence and AI solutions. Our mission is to transform data into a strategic and competitive asset by fostering collaboration and innovation.

• Enable the democratization and productization of data assets to drive insights and decision-making.
• Develop new data and product capabilities through advanced analytics and AI-driven solutions.
• Collaborate closely with business units and enterprise functions to maximize the impact of data.
• Leverage intelligence solutions to unlock efficiency, transparency, and value across the organization.
  
  

Key Responsibilities

• Partner with Product Owners, Product Managers, and the Director of DI (Provider) to define and prioritize data strategies that drive impactful product development in the US Healthcare Providers domain.
• Act as a data liaison, providing actionable insights to stakeholders and guiding the integration of diverse data sources into product workflows.
• Perform in-depth analyses of provider data to identify trends, patterns, and actionable insights that influence business strategies.
• Implement and lead comprehensive data quality assurance processes, ensuring the accuracy and consistency of provider data.
• Support provider demographic services, network solutions and credentialing services by leveraging data from existing Datawarehouse, MDM data stores.
• Work closely with the IT and Data Engineering teams to ensure data is stored, processed, and accessed in a compliant and secure manner, incorporating data from identified sources.
• Assist in the development and implementation of data governance policies and procedures, ensuring the inclusion of data from relevant sources.
• Mentor junior analysts and provide guidance on best practices in data analysis, governance, and visualization.
• Stay up to date with industry trends and best practices in data analysis, provider data management, and healthcare fintech, and continuously identify new data sets to enhance outcomes.
  
  

Qualifications

• Bachelor’s degree in computer science, Information Systems, or a related field.
• 8+ years of experience in data analysis, preferably in the healthcare or fintech industry, with a strong understanding of the US healthcare system, including the roles and interactions between providers, payers, and patients.
• Strong proficiency in SQL and experience with data visualization tools (e.g., Power BI, Sigma), with the ability to analyze and present complex healthcare data effectively.
• Proficiency with Snowflake and DBT (40 % of the role), leveraging these tools to manage and analyze large datasets within the healthcare domain.
• Basic knowledge of Python for data analysis tasks (40 % of the role), including data manipulation and automation of routine tasks.
• Experience with Datawarehouse and MDM systems, particularly in managing provider data, including provider demographic services and credentialing services.
• Excellent analytical and problem-solving skills with a keen attention to detail, particularly in identifying trends and patterns in healthcare data.
• Strong leadership and mentoring abilities. Ability to manage and prioritize multiple projects in a dynamic, fast-paced environment.
• Understanding of data privacy and compliance regulations, particularly in the healthcare industry, including key healthcare legislation and regulations such as the Affordable Care Act (ACA), Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA).
• Knowledge of third-party data systems such as Dun & Bradstreet (D&B) and the Centers for Medicare & Medicaid Services (CMS) for provider data management.
• Ability to manage multiple tasks and projects simultaneously in a fast-paced environment, with a focus on improving provider data management processes and outcomes.
• Ability to manage multiple tasks and projects simultaneously in a fast-paced environment.
  
  

Preferred Qualifications

• Experience with healthcare data standards and regulations (e.g., HIPAA), ensuring compliance and data integrity in all data management activities.
• Familiarity with data governance frameworks and best practices, particularly in the context of healthcare data management.
• Advanced degree in Data Science, Computer Science, Information Systems, or a related field.
• In-depth knowledge of the US healthcare system, including:
• Healthcare Triangle: Understanding the roles and interactions between providers, payers, and patients.
• Provider Networks: Knowledge of how provider networks are structured and managed, including credentialing and contracting processes.
• Regulatory Environment: Awareness of key healthcare legislation and regulations, such as the Affordable Care Act (ACA), Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA).
• Reimbursement Models: Understanding of various reimbursement models, including fee-for-service, value-based care, and capitation.
• Healthcare Data Standards: Knowledge of standards such as ICD-10, CPT, and HL7.