L.A. Care Health Plan · 1 day ago
Enterprise Data Analyst III
Los Angeles, CA
Full-time
Onsite
Mid, Senior Level
$89K/yr - $142K/yr
4+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, dedicated to providing health coverage to low-income Los Angeles County residents. The Enterprise Data Analyst III will lead complex analytic projects to drive insights that support enterprise goals and performance improvement, while mentoring other staff and ensuring high-quality outputs.
FitnessGovernmentHealth Care
Responsibilities
Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights
Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance
Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows
Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases
Maintains awareness of data lineage and governance compliance throughout all analytic work
Manages project planning, tracking, and post-implementation assessment for assigned deliverables
Mentors and models adherence to analytic development best practices
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
Perform other duties as assigned
Qualification
Required
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution
Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams
Ability to analyze operational Key Performance Indicators (KPIs) (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights
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 findings into actionable insights for strategy and business planning
Experience with risk adjustment methodologies, including Hierarchical Condition Category (HCC) coding, hierarchical models, and member risk scoring
Knowledge of diagnosis documentation, encounter data, and coding completeness to optimize plan revenue and quality scores
Knowledge of regulatory requirements impacting risk adjustment (e.g., Centers for Medicare and Medicaid Services (CMS) guidelines)
Ability to assess encounter submission and processing operations, identifying trends, anomalies, or gaps in risk capture across provider or member populations
Experience analyzing medical cost drivers across populations, conditions, and service types
Experience developing dashboards or analytic tools to monitor and optimize medical spend
Knowledge of claims, provider, and condition level analyses to support financial and operational decision making
Ability to identify high-cost services, utilization patterns, and opportunities for cost containment
Bachelor's Degree
At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health
Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights
Experience analyzing multiple data sources and translate findings into actionable recommendations
Expert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes supporting enterprise dashboards, reports, and analytic deliverables
Advanced proficiency in Tableau (or equivalent BI tools) to design, optimize, and automate dashboards and visualizations for enterprise level insights
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts to identify drivers of operational, clinical, and financial performance
Knowledge of version control (Git, GitHub) and collaborative development workflows, including peer review, continuous integration, and reproducible analytic practices
Ability to develop and maintain reusable analytic frameworks, templates, and processes that support recurring reporting and performance monitoring
Proficiency in data validation, reconciliation, and adherence to governance standards, including data lineage tracking and quality control
Ability to translate complex business problems into structured analytic requirements and actionable insights
Ability to interpret analytic results in the context of organizational performance, operational priorities, and enterprise goals
Ability to apply critical thinking to identify patterns, opportunities, and risks across multiple data domains
Ability to collaborate effectively with IT, operational teams, and business partners to operationalize analytic outputs
Demonstrated knowledge of healthcare concepts, such as quality measures, utilization patterns, and key operational drivers in a managed care environment
Ability to lead analytic projects end-to-end, including business case definition, requirements gathering, analysis, and post-implementation assessment
Ability to mentor junior analysts and promote adherence to analytic best practices
Ability to manage multiple projects simultaneously, prioritize tasks, and escalate issues appropriately
Ability to communicate findings effectively to both technical and non-technical stakeholders
Tableau Certified Data Analyst or Tableau Desktop Specialist
Microsoft Certified: Power BI Data Analyst Associate
Snowflake SnowPro Core Certification
SnowPro® Specialty: Snowpark Certification
SQL Certification (e.g., DataCamp SQL Associate Certificate, Codecademy SQL Professional Certification, W3Schools SQL Certification)
Certified Health Data Analyst (CHDA)
Managed Care Professional (MCP) or relevant certification
Experience analyzing community supports, care management, health education, Managed Long-Term Support Services (MLTSS), and intervention programs
Experience translating data into actionable insights to guide interventions, resource allocation, program improvements, and new ideas for member programs based on population needs
Knowledge of population health management frameworks and social determinants of health
Ability to evaluate population level outcomes and operational performance metrics
Experience analyzing Healthcare Effectiveness Data and Information Set (HEDIS), Stars, and other quality measurement programs across both medical and pharmacy domains
Experience translating data into actionable insights to inform interventions, compliance, and performance improvement strategies
Knowledge of quality measurement frameworks, regulatory requirements, and reporting standards
Ability to evaluate performance metrics, trends, and gaps to support quality improvement initiatives
Experience analyzing appointment timeliness, access, and provider availability
Experience translating data into actionable insights to improve access, reduce barriers, and optimize provider scheduling
Experience supporting initiatives to improve network adequacy and member access, including operational interventions and performance monitoring
Knowledge access measurement frameworks and regulatory requirements
Ability to evaluate member access metrics, network capacity, and operational performance
Experience supporting enterprise level KPI maintenance, cross domain dashboards, and measure ROI analyses
Ability to develop analytic tools and dashboards that consolidate insights across multiple domains
Experience translating data into actionable insights for strategic investments, operational decisions, and organizational performance monitoring
Preferred
AAPC Certified Risk Adjustment Coder (CRC®)
Practice Management Institute Certified Risk Adjustment and HCC Coder (CRA-HCC™)
NAMAS Certified HCC Coder (CHCC™)
AHIMA Certified Coding Specialist (CCS®)
Experience with advanced analytics techniques, including multivariate analysis, regression, control charts, or predictive modeling
Experience in domain specific operations, such as network strategy, risk adjustment, or medical cost driver analysis
Experience mentoring junior analysts or providing guidance on analytic best practices
Experience understanding and responding to ongoing California Department of Health Care Services (DHCS) requirements for various programs, such as CalAIM
Experience supporting quality reporting requirements and initiatives for regulatory or accreditation programs (e.g., CMS, DHCS)
Experience supporting provider focused incentive program analytics
Certified Professional in Healthcare Quality (CPHQ)
Experience supporting talent development analytics or enterprise-wide strategic initiative evaluation
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
H1B Sponsorship
L.A. Care Health Plan has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (1)
2023 (1)
2021 (3)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
MarketScreener
2025-08-27
2025-08-04
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