L.A. Care Health Plan · 16 hours ago
Authorization and Claims Analytics Data Analyst III
1200 Building
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 residents in Los Angeles County. The Authorization and Claims Analytics Data Analyst III is responsible for leading complex analytic projects that drive enterprise goals and performance improvement, utilizing advanced analytic reasoning and business acumen to deliver actionable insights.
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
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 translating findings into actionable recommendations
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
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
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
Preferred
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
Proficient with Process Improvement Methodology including defining and documenting workflow
Knowledge of program and project level planning, mobilization and management
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
2026-01-17
MarketScreener
2025-08-27
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