Operations Data Analyst II

Gold Coast Health Plan

. Perform advanced statistical and quantitative analysis of healthcare, operational, claims, encounter, membership, and enterprise data .

Posted 11/6/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $100,000 - $150,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in advanced statistical analysis and data modeling, utilizing SQL, Python, R, and Power BI to derive insights from complex datasets. Capable of communicating analytical findings effectively to diverse audiences while ensuring compliance with organizational and regulatory standards.

Highest-signal resume keywords

Advanced SQL/T-SQLStatistical AnalysisData Visualization Using Power BIData Quality AssessmentAnalytical Solution Development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Statistical ModelingRegression AnalysisHypothesis TestingForecastingSegmentationOutlier DetectionTrend AnalysisData ProfilingData ValidationData Reconciliation

Soft Skills

CommunicationCollaborationAnalytical ThinkingProblem-SolvingTechnical Guidance

Tools & Technologies

SQLPythonRPower BIMicrosoft Azure SynapseMicrosoft Office

Industry Keywords

Healthcare Data AnalysisOperational KPIsEnterprise AnalyticsGrievances & AppealsRisk AdjustmentClaims AnalysisMembership Analysis

Tech Stack

Tools & technologies

AzurePythonSQL

About the role

Key responsibilities & impact

Perform advanced statistical and quantitative analysis of healthcare, operational, claims, encounter, membership, and enterprise data
Develop statistical models and algorithms to identify anomalies, patterns, trends, risks, and opportunities
Apply regression, hypothesis testing, forecasting, segmentation, outlier detection, trend analysis, and other quantitative techniques
Develop and maintain analytical solutions using SQL, Python, R, Power BI, and other approved tools
Serve as analytical owner or subject matter resource for assigned operational domains
Develop enterprise dashboards, reports, data visualizations, and analytical products
Automate recurring analytical processes, regulatory metrics, operational KPIs, and data validation activities
Analyze complex datasets from multiple sources and identify relationships, trends, data-quality issues, and improvement opportunities
Perform data profiling, validation, reconciliation, and quality analysis
Develop and maintain data models, analytical datasets, data definitions, and source-to-target mapping documentation
Partner with business stakeholders to define analytical questions, methodologies, success measures, and recommendations
Collaborate with Information Technology, Enterprise Analytics, developers, data engineers, consultants, and technical resources
Support enterprise data warehouse solutions, including Microsoft Azure Synapse
Develop analytical solutions supporting Grievances & Appeals, Encounters, Risk Adjustment, Claims, Membership, and related areas
Evaluate claims and encounter patterns and anomalies indicating operational issues, payment variation, data-quality concerns, or investigation opportunities
Measure operational performance, identify statistically significant variation, and evaluate operational interventions
Perform exploratory data analysis for new models, measures, and decision-support tools
Document methodologies, assumptions, limitations, data sources, and results
Present complex analytical findings to technical and non-technical audiences
Provide analytical guidance and technical support to Data Analyst I staff and Operations Analytics team members
Participate in cross-functional projects and enterprise initiatives
Maintain awareness of emerging analytical techniques and technologies and recommend capability improvements
Ensure analytical solutions meet business, organizational, and regulatory requirements
Perform other duties as assigned

Requirements

What you’ll need

Bachelor's degree in Statistics, Mathematics, Data Science, Computer Science, Economics, Information Systems, Business Analytics, or another quantitative or related field, or nine (9) or more years of progressively responsible relevant experience in lieu of degree
Five plus (5+) or more years of progressively responsible experience performing data analysis, statistical analysis, business intelligence, or related analytical work
Demonstrated experience writing complex SQL queries and working with relational databases
Demonstrated experience developing reports, dashboards, or analytical solutions using Power BI or another data visualization platform
Experience applying statistical methods to business or operational problems
Advanced SQL/T-SQL
Relational databases
Power BI or comparable data visualization platform
Advanced Microsoft Office skills
Ability to apply quantitative and statistical methods to complex business problems
Ability to select appropriate analytical methodologies and evaluate statistical results
Ability to assess data accuracy, completeness, consistency, and appropriateness
Ability to document analytical methods, findings, assumptions, and recommendations
Ability to communicate complex analytical concepts to technical and non-technical audiences