Digital360Solutions LLC in Houston, TX is seeking an experienced Data Analyst to Analyze and integrate healthcare datasets—including large-scale structured and semi-structured claims, EHR, enrollment, billing, pharmacy, utilization, provider, financial, and patient satisfaction data—to support statistical modeling, quality measurement, provider performance analytics, operational intelligence, and population health initiatives.

Duties:

Design and maintain scalable, analysis-ready datasets and data pipelines through ETL processes, reconciliation, transformation, feature engineering, and governance frameworks across enterprise healthcare systems.

Develop dashboards, scorecards, and executive reports using Power BI, Tableau, SSRS, and Excel to track HEDIS, CMS STAR Ratings, NCQA, CAHPS, readmissions, utilization, care gaps, medical cost trends, MLR, provider satisfaction, and risk adjustment performance.

Perform advanced analytics including predictive modeling, forecasting, utilization and cost analysis, member stratification, and outcomes measurement to identify trends, improve efficiency, reduce costs, and support value-based care initiatives. Evaluate inpatient, outpatient, emergency, specialty, medical, and pharmacy claims data to uncover care gaps, utilization patterns, financial drivers, and quality improvement opportunities.

Monitor provider quality and operational metrics related to HEDIS, STAR Ratings, CAHPS, utilization, financial performance, and population health outcomes. Create provider scorecards, patient rosters, care gap analyses, and corrective action plans to improve provider engagement, network performance, retention, and value-based reimbursement outcomes..