Senior Claims Data Analyst

Senior Claims Data Analyst

Global Appropriateness Measures (GAM) is a collaboration of healthcare experts committed to the goal of measuring high-value care and reducing waste. Using the principles of practice pattern measurement, clinical wisdom, and medical evidence, GAM seeks to promote a safer, higher quality and more efficient healthcare system.

We are seeking a highly skilled Senior Healthcare Data Analyst to join GAM´s fully remote team. This individual will work closely with a mission-driven team whose goal is to reduce unnecessary care in order to make our healthcare system more affordable to everyone. This role involves analyzing complex healthcare claims to support the creation of quality and outcomes measures.  The ideal candidate will have expertise in data analytics, healthcare systems, and statistical modeling.

Job Description:

• Analyze large healthcare claims datasets (e.g., EHR, Medicare/Medicaid VRDC, commercial/public data).

• Develop and implement quality metrics to identify excessive or inappropriate practice patterns at the physician (NPI) level.

• Prepare, manage, and interpret healthcare data; report results and create visualizations.

• Support data acquisition and business development related to healthcare data sources.

• Translate clinical measure specifications into code to generate analytical outputs.

• Collaborate with clinical teams on defining and refining quality and outcome measures.

• Participate in team meetings and contribute to broader business needs.

Qualifications

• Over 7 years of experience in the healthcare data analytics industry.

• Proficiency in SQL.

• Familiarity with additional analytical tools such as R and Python.

• Knowledge of U.S. healthcare data, including key coding systems like HCPCS, CPT or ICD.

• Experience handling healthcare claims across Commercial, Medicare, and Medicaid programs.

• Strong capabilities in data visualization, storytelling, and presentation development.

• Highly accountable, with a strong commitment to delivering accurate and high-quality work.

• Sharp critical thinking and analytical reasoning abilities, and attention to detail.