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SmartLight Analytics

Harness the power of your healthcare data

Claims Data Strategy Lead

StrategyStrategyFull TimeRemoteSeniorTeam 1-10Since 2016H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

3 days ago

Salary

0

Seniority

Senior

Bachelor Degree10 yrs expEnglishSQL

Job Description

Claims Data Strategy Lead

SmartLight Analytics

• Own and drive end‑to‑end solutions across healthcare claims data initiatives, from problem definition through implementation and validation. • Serve as a senior authority on medical, pharmacy, behavioral health, dental, DME, and ancillary claims data. • Design, build, and optimize advanced SQL‑based data models, views, and automation frameworks with a focus on performance, scalability, and maintainability. • Develop and maintain complex claim adjustment sequencing and disposition logic, including support for split claims and multiple, disparate source configurations. • Build utilization metrics tied directly to underlying service‑level data, including inpatient, outpatient, professional, and behavioral health levels of care. • Apply deep expertise in healthcare transactions and standards, including 837, 834, 820, HL7, and CCDA, to ensure data accuracy and analytical integrity. • Proactively identify data gaps, risks, and improvement opportunities and drive them to resolution without waiting for direction. • Partner closely with product, analytics, engineering, and leadership teams to ensure claims data assets support broader business and client goals.

Job Requirements

  • Bachelor’s degree in Computer Science, Information Systems, or related field (or equivalent practical experience)
  • 7-10 years of experience working with healthcare data, with deep specialization in claims data and analytics
  • Expert‑level proficiency in SQL and advanced query development across large, complex datasets
  • Extensive experience building and optimizing complex data models, views, and automation frameworks within SQL platforms
  • Strong understanding of healthcare claims data structures, including medical, pharmacy, behavioral health, and ancillary claims
  • Demonstrated ability to develop and maintain complex claim adjustment sequencing and disposition logic
  • Proven ability to independently assess unfamiliar data environments and rapidly develop working solutions
  • Strong analytical, problem‑solving, and critical‑thinking skills
  • Excellent communication and collaboration abilities across technical and non‑technical stakeholders
  • Ability to work independently, take full ownership of initiatives, and manage multiple priorities with minimal oversight.

Benefits

  • Health insurance
  • Professional development opportunities

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