Business Intelligence Analyst, Lead II

Role Description

Business Intelligence Analyst, Lead II

Lead II - Data Science

Who We Are

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

UST HealthProof is looking for an experienced Lead Business Intelligence Analyst, reporting to the Director of Reporting and Analytics. The Business Intelligence Analyst, Lead II has a robust background in health plan operations. In this role, you will combine your deep operational expertise—covering claims, utilization, and financial performance—with advanced analytical techniques to transform complex data into actionable strategic insights. Your experience in health plan operations is crucial to guiding informed decision-making and enhancing overall performance.

The Opportunity

• Provide analysis of large and complex data sets, including claims, eligibility, provider data, clinical data, appeals, grievances, and contact center to identify patterns, trends, and anomalies to determine operational impacts.
• Provide actionable insights that support strategic decision making and operational improvements.
• Collaborate with key internal stakeholders to recommend improvements to workflows, ensuring alignment with overall business and operational goals.
• Create forecasting models to assist in resource planning, budgeting, and financial reporting.
• Present complex data analyses to senior leadership, clinical teams, and non-technical stakeholders in a clear and actionable manner, influencing decision-making on key operational initiatives.
• Provide ongoing training and support to business teams on best practices for data usage, report interpretation, and analysis tools.
• Lead collaborative projects to implement data-driven strategies that enhance the overall business operations and improve outcomes.
• Ensure all data analysis and reporting processes are fully aligned with industry standards and regulatory requirements (e.g., CMS, ACA, HIPAA).
  
  

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need

• Bachelor’s degree in Data Science, Statistics, Mathematics, Public Health, Health Informatics, or a related field. Master’s degree or professional certifications (e.g., Certified Health Data Analyst, SAS) is preferred.
• Minimum of 5+ years of experience in data intelligence analysis, focused on health plan operations, healthcare analytics, or managed care.
• Proven track record of successfully analyzing and interpreting complex healthcare data (claims, member, financial, and operational datasets).
• In-depth experience with healthcare data systems and processes.
• Strong understanding of health plan operations, in all or some of the following areas: claims, care management, contact center, eligibility, and appeals and grievances.
• Strong quantitative and qualitative analysis skills with the ability to extract actionable insights from complex datasets.
• Expertise in statistical methodologies and experience applying these techniques to healthcare datasets to drive operational improvements and financial outcomes.
• Ability to think critically, identify trends and potential issues, and provide data-driven recommendations.
• Expertise in data analysis tools such as SQL, Excel, Tableau, Power BI, and other reporting/analytics software.
• Solid understanding of database management, data warehousing, ETL processes, and data integration methods.
• Experience with health plan-specific software (e.g., claims management platforms, care management and call center).
• Experience with managed care systems and familiarity with clinical data (e.g., ICD-10, CPT codes).
• Exceptional communication skills, with the ability to present complex data in a clear, concise, and actionable way to both technical and non-technical stakeholders.
• Experience working closely with cross-functional teams (Tech Ops, Claims, Contact Center, Medical Management) to deliver on project goals.
  
  

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $100,000-$105,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

• Simplicity
  
  

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

• Integrity
  
  

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

• People-Centricity
  
  

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

• Leadership
  
  

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

#Healthproof

#CB

Skills

Healthcare,Reporting,Reporting Tools