Position Title: Business Intelligence Analyst
Department: Care Management
Reports to: VP and/or Sr. Director, Care Management
FLSA Status: Full-Time, Exempt
Location: Hybrid
Pay Range: $31.82-$40.82 per hour
Summary
We are seeking a Business Intelligence (BI) Analyst to support data-driven decision-making and ensure compliance with the performance, reporting, and operational requirements defined by our Managed Care Plan (MCP) and healthcare partners. This role blends data analysis with business process understanding, ensuring that contract requirements are accurately translated into internal workflows, metrics, and reporting outputs.
The BI Analyst will collaborate with program leaders, quality teams, and external partners to validate that our services are delivered in alignment with contract expectations, regulatory guidelines, and organizational goals. This position is key to ensuring data accuracy, improving program performance, and strengthening accountability to the communities we serve.
Key Responsibilities
Contract & Program Requirements Alignment
- Interpret data-related requirements from Managed Care Plans, healthcare contracts, Statements of Work (SOWs), and regulatory guidance.
- Translate contractual obligations into clear internal metrics, dashboards, and reporting specifications.
- Work with program leadership to define what data must be collected, monitored, and reported to demonstrate compliance and program effectiveness.
- Ensure that data solutions support program workflows, case management activities, and service delivery expectations.
Data Analysis & Reporting
- Develop dashboards and performance reports to track program outcomes, service utilization, timeliness standards, and contractual KPIs.
- Conduct analyses to identify gaps, trends, and performance risks related to contract deliverables.
- Support audits, quality reviews, and MCP reporting submissions through validated, accurate data outputs.
- Analyze client-level and population-level data to help improve service delivery and program impact.
Quality Improvement & Operational Support
- Partner with Quality Assurance, Program Managers, and Compliance teams to evaluate program performance against required standards.
- Provide data insights that inform corrective action plans, quality improvement initiatives, and operational changes.
- Recommend better processes for data collection, documentation, and outcome tracking.
Cross-Functional Collaboration
- Act as a bridge between program staff, leadership, IT/data teams, and contracted partners.
- Communicate technical data concepts in clear, business-oriented language.
- Participate in meetings with MCP partners and internal teams to align on reporting expectations and performance results.
Data Governance & Accuracy
- Maintain consistent definitions of key program metrics, compliance indicators, and quality measures.
- Conduct regular data validations to ensure accuracy in case management systems, EHRs, or other data platforms.
- Support the development of documentation such as data dictionaries, reporting guides, and metric definitions.
Required Qualifications
- Bachelor’s degree in Public Health, Social Work Administration, Data Analytics, Information Systems, Business Administration, or related field.
- 2+ years of experience in data analysis, business intelligence, or business analysis — ideally in healthcare, nonprofit, social services, or managed care.
- Experience with BI tools (Power BI preferred; Tableau or Looker also acceptable).
- Strong SQL skills for querying relational databases.
- Knowledge of data structures used in case management, EHR, or care coordination systems.
- Ability to translate complex business and contract requirements into data specifications and dashboards.
- Strong written and verbal communication skills with ability to present findings to non-technical stakeholders.
Preferred Qualifications
- Experience working with Managed Care Plans, Medicaid/Medicare programs, or healthcare quality measures (e.g., HEDIS, PHM).
- Familiarity with social services workflows such as care coordination, referral management, client engagement, SDOH (Social Determinants of Health), and case management documentation.
- Background in nonprofit contract reporting, grant reporting, or regulatory compliance.
- Experience with ETL processes or data warehouse environments.
- Knowledge of quality improvement frameworks (e.g., PDSA, CQI).
- Exposure to healthcare interoperability or data exchange formats (e.g., 834/837 files, HL7, FHIR).
Key Competencies
- Ability to balance business needs with data/technical logic
- Strong analytical mindset with attention to detail
- Excellent stakeholder engagement and relationship-building skills
- Mission-driven approach centered on client outcomes and community impact
- Strong organizational and project management abilities
- Skilled at translating complex requirements into actionable insights
What This Role Delivers
- Accurate, validated dashboards aligned with MCP contract requirements
- Clear and consistent metric definitions organization-wide
- Insights that directly improve program performance, compliance, and client outcomes
- A strong connection between program needs and data solutions
- A more accountable, data-driven, and efficient organization
Job Acknowledgement
The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions and perform any other related duties as assigned by their supervisor. Partners in Care Foundation reserves the right to alter the field work arrangement at any time with or without notice.