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Health Plan Analyst Jobs (NOW HIRING)

reveleer

Senior Actuary, Health Plan Analytics

$150K - $185K/yr

Senior Actuary, Health Plan Analytics Remote Opportunity About Reveleer Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member ...

Scanhealthplan

Actuarial Analyst - Health Plan

Prepare and analyze data for Part D and develop comparisons between actual versus forecast ... are, health plan, or managed care focus, or comparable actuarial consulting experiences.

BrightSpring

3rd Party Plan Analyst

Louisville, KY

The 3rd Party Analyst is responsible for configuring 3rd party insurance setups within our ... Health, dental, & vision * Company paid STD & LTD * Paid Time Off * Flexible Schedules * Tuition ...

PharMerica

3rd Party Plan Analyst

Louisville, KY · On-site +1

The 3rd Party Analyst is responsible for configuring 3rd party insurance setups within our ... Health, dental, & vision * Company paid STD & LTD * Paid Time Off * Flexible Schedules * Tuition ...

PharMerica

3rd Party Plan Analyst

Louisville, KY · On-site +1

The 3rd Party Analyst is responsible for configuring 3rd party insurance setups within our ... Health, dental, & vision * Company paid STD & LTD * Paid Time Off * Flexible Schedules * Tuition ...

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Health Plan Analyst information

What is a health plan analyst?

Health Plan Analysts are professionals who evaluate, design, and manage health insurance plans for organizations or insurance companies. They analyze data related to healthcare costs, utilization, and plan performance to ensure that health plans are cost-effective and compliant with regulations. Their work often involves collaborating with actuaries, benefits managers, and healthcare providers to optimize plan offerings and improve member satisfaction. Health Plan Analysts also help identify trends, forecast future needs, and recommend changes to existing plans based on their analysis.

What are the key skills and qualifications needed to thrive as a health plan analyst, and why are they important?

To thrive as a Health Plan Analyst, you need strong analytical skills, knowledge of healthcare regulations, and a background in statistics, economics, or public health, often supported by a relevant bachelor’s degree. Familiarity with data analysis tools such as Excel, SQL, and healthcare-specific software like SAS or Tableau, as well as understanding HIPAA compliance, is typically required. Excellent communication, problem-solving, and attention to detail help analysts interpret data and convey insights to stakeholders. These skills are vital for optimizing health plan performance, ensuring regulatory compliance, and supporting data-driven decision-making in healthcare organizations.

What are some common challenges health plan analysts face when interpreting healthcare data, and how can they overcome them?

Health Plan Analysts often encounter challenges such as inconsistent data sources, complex regulatory requirements, and rapidly changing healthcare policies. To overcome these, analysts must develop strong analytical skills, stay current with industry guidelines, and maintain close collaboration with cross-functional teams like IT, compliance, and clinical departments. Leveraging data visualization tools and ongoing professional development can also help ensure accurate analysis and effective communication of findings.

What cities are hiring for Health Plan Analyst jobs?

Cities with the most Health Plan Analyst job openings:

What states have the most Health Plan Analyst jobs?

States with the most job openings for Health Plan Analyst jobs include:

What are popular job titles related to Health Plan Analyst jobs?

For Health Plan Analyst jobs, the most frequently searched job titles are:

Infographic showing various Health Plan Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Health Plan Data Analyst II (Health Plan Experience)

Dayton, OH • On-site, Remote

CareSource
Insurance Services • 1 - 5K employees
Learn more about CareSourceexternal

$62K - $100K/yr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

Job Summary:
The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces.
Essential Functions:
  • Participate as a member of Health Partner Lifecycle (HPLC) team to support existing provider data operations and new market implementations
  • Perform disruption analysis activities for assigned markets
  • Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements
  • Serve as Project Manager for select HPLC initiatives
  • In conjunction with HPLC management team, develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development
  • In conjunction with HPLC management team, coordinate activities with regard to provider network data management and reporting
  • Develop database structures and reports as needed
  • Develop queries to aid in information retrieval, validation and updating of provider databases
  • Review provider organizations and systems for development of analyses that support contract negotiation and provider recruitment processes
  • Work with both internal and external partners to gain information for provider network reporting and analyses
  • Coordinate and track all State files, hospital, physician and ancillary recruitment information
  • Prepare NCQA documentation for assigned markets as appropriate
  • Act as Subject Matter Expert for provider data and impacts to downstream processes
  • Perform any other job duties as requested

Education and Experience:
  • Bachelor's degree or equivalent years of relevant work experience is required
  • Minimum of three (3) years of data analysis or experience in a health care setting is required
  • Experience with Cognizant Facets Provider application is required
  • Managed care experience is preferred
  • Project management experience is preferred

Competencies, Knowledge and Skills:
  • Advanced Microsoft Excel, Access, and Word skills
  • Knowledge and understanding of Facets data model
  • Proficient in data analysis and use of analytics / reporting tools such as Power BI
  • Demonstrates analytical and supporting technical skills to include SQL capabilities
  • Experience with Visio and PowerPoint preferred
  • Working knowledge of provider data repositories and directories preferred
  • Ability to work independently and within a team environment
  • Excellent written and verbal communication skills
  • Ability to meet tight deadlines
  • Extreme flexibility as projects and priorities shift

Licensure and Certification:
  • None

Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$62,700.00 - $100,400.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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Brand=CareSource

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