L.A. Care Health Plan · 2 days ago
Enterprise Data Analyst II
Los Angeles, CA
Full-time
Onsite
Mid Level
$77K/yr - $124K/yr
3+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, providing health coverage to low-income Los Angeles County residents. The Enterprise Data Analyst II collaborates in the design, development, and delivery of analytic solutions to inform operational, quality, and financial performance across the organization.
FitnessGovernmentHealth Care
Responsibilities
Translate defined business questions into structured analytic requirements and specifications
Participate in structured requirements elicitation, documentation, and verification
Develop and automate recurring reports and dashboards, applying standardized definitions and refresh cycles (daily, weekly, monthly, quarterly)
Validate data integrity and ensure compliance with data lineage and governance standards
Contribute to analytic code review and continuous integration processes to maintain transparency, version control, and quality
Collaborate with IT, business partners, and fellow analysts to resolve data issues and confirm analytic accuracy
Apply foundational statistical methods (e.g., control charts, variance analysis) to interpret patterns in performance
Participate in project tracking and post-implementation review to ensure solutions deliver measurable business value
Perform other duties as assigned
Qualification
Required
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics
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
Experience supporting initiatives to optimize cost, access, and quality within provider networks
Experience analyzing provider networks, including contracting, credentialing, and panel optimization
Ability to evaluate network performance metrics and translate findings into actionable insights for strategy and business planning
Experience with risk adjustment methodologies, including Hierarchical Condition Category (HCC) coding, hierarchical models, and member risk scoring
Knowledge of diagnosis documentation, encounter data, and coding completeness to optimize plan revenue and quality scores
Knowledge of regulatory requirements impacting risk adjustment (e.g., Centers for Medicare and Medicaid Services (CMS) guidelines)
Ability to assess encounter submission and processing operations, identifying trends, anomalies, or gaps in risk capture across provider or member populations
Experience analyzing medical cost drivers across populations, conditions, and service types
Experience developing dashboards or analytic tools to monitor and optimize medical spend
Knowledge of claims, provider, and condition level analyses to support financial and operational decision-making
Ability to identify high-cost services, utilization patterns, and opportunities for cost containment
Bachelor's Degree
At least 3 years of experience in analytics, data management, or reporting, preferably within healthcare, managed care, or a related industry
Hands-on experience with SQL, reporting tools (Tableau, Power BI), and operational dashboards
Experience in one or more domains (Authorization & Claims, Population Health, Quality, etc.) at a functional or project level
Proficient in SQL for complex exploratory analysis and foundational Extract, Transform, and Load (ETL) work to support dashboards, reports, and analytic deliverables
Working knowledge of Tableau for building standard visualizations and dashboards
Knowledge of version control tools (e.g., Git, GitHub) and collaborative development workflows
Ability to conduct analyses to identify trends, patterns, and opportunities across organizational data
Ability to translate business questions into structured requirements and actionable insights
Ability to apply descriptive statistics and basic trend analysis to support operational decision-making
Knowledge of general operations and performance drivers in a complex, data driven organization
Ability to use Jira or Atlassian tools for task tracking and coordination within analytics projects
Ability to communicate findings effectively to business partners with varying technical backgrounds
Ability to work on multiple assignments simultaneously, prioritize tasks and know when to escalate issues
Ability to work under challenging deadlines
Experience analyzing call center operations, enrollment services, and appeals & grievances
Experience translating data into actionable insights to improve member experience and member engagement operations
Knowledge of Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys or other member satisfaction measurement tools
Ability to assess member touchpoints, satisfaction metrics, and operational KPIs
Experience analyzing community supports, care management, health education, Managed Long-Term Support Services (MLTSS), and intervention programs
Experience translating data into actionable insights to guide interventions, resource allocation, program improvements, and new ideas for member programs based on population needs
Knowledge of population health management frameworks and social determinants of health
Ability to evaluate population level outcomes and operational performance metrics
Experience analyzing Healthcare Effectiveness Data and Information Set (HEDIS), Stars, and other quality measurement programs across both medical and pharmacy domains
Experience translating data into actionable insights to inform interventions, compliance, and performance improvement strategies
Knowledge of quality measurement frameworks, regulatory requirements, and reporting standards
Ability to evaluate performance metrics, trends, and gaps to support quality improvement initiatives
Experience analyzing appointment timeliness, access, and provider availability
Experience translating data into actionable insights to improve access, reduce barriers, and optimize provider scheduling
Experience supporting initiatives to improve network adequacy and member access, including operational interventions and performance monitoring
Knowledge of access measurement frameworks and regulatory requirements
Ability to evaluate member access metrics, network capacity, and operational performance
Experience supporting enterprise-level KPI maintenance, cross-domain dashboards, and measure ROI analyses
Experience translating data into actionable insights for strategic investments, operational decisions, and organizational performance monitoring
Knowledge of analytics frameworks, governance standards, and enterprise reporting processes
Ability to develop analytic tools and dashboards that consolidate insights across multiple domains
Preferred
Master's Degree
Experience in health plan operations or managed care analytics
Experience participating in enterprise reporting or dashboard projects with governance standards
Experience understanding and responding to ongoing California Department of Health Care Services (DHCS) requirements for various programs, such as CalAIM
Experience supporting quality reporting requirements and initiatives for regulatory or accreditation programs (e.g., CMS, DHCS)
Experience supporting provider focused incentive program analytics
Experience supporting talent development analytics or enterprise-wide strategic initiative evaluation
Tableau Certified Data Analyst or Tableau Desktop Specialist
Microsoft Certified: Power BI Data Analyst Associate
Snowflake SnowPro Core Certification
SnowPro® Specialty: Snowpark Certification
Certified Health Data Analyst (CHDA)
Certified Analytics Professional (CAP)
SQL Certification (e.g., DataCamp SQL Associate Certificate, Codecademy SQL Professional Certification, W3Schools SQL Certification)
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
MarketScreener
2025-08-27
2025-08-04
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