Global Appropriateness Measures LLC Senior Data Analyst, Quality Remote · Full time Company website

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GAM is a consortium of physicians dedicated to advancing patient outcomes through data-driven insights and innovative metrics rooted in clinical expertise. We are the gold standard in healthcare appropriateness measurement, and our primary focus is on measuring clinical waste—a priority area for health systems, health plans, self-funded employers, and data analytics companies. We’re a fast-moving, high-growth company helping people navigate healthcare smarter - saving money, avoiding unnecessary care, and getting better outcomes. We partner with employers and other industry leaders to help their teams make better healthcare decisions.

KEY RESPONSIBILITIES 

Analytics & Measure Development 

• Integrate data from VRDC Medicare/Medicaid claims, commercial claims, EHRs and public health sources to develop, validate, and implement quality healthcare metrics at the physician and facility level. 
• Identify practice patterns that constitute excessive, inappropriate, or low-value services and quantify their prevalence and impact across provider populations. 
• Collaborate with the clinical team to refine measure specifications and translate those specifications into production-ready code to generate reliable outputs. 
• Develop and deploy statistical models to support measure development, trend analysis, and practice pattern identification. 

Data Management & Reporting 

• Manage, prepare, cleanse, and validate data from multiple sources; document data pipelines and analytical methodologies. 
• Support data acquisition and business development activities involving new data sources and external partnerships. 

Stakeholder Communication & Collaboration 

• Prepare clear written narrative summaries of findings for both technical and non-technical audiences. 
• Develop and deliver executive-level presentations that translate complex analytical results into actionable insights for clinical, operational, and leadership stakeholders. 
• Engage proactively with clinical teams to understand measure intent and ensure analytical outputs align with real-world care delivery context. 
• Participate in team meetings, cross-functional working groups, and contribute to broader organizational and strategic initiatives. 

EDUCATION 

• Bachelor's degree in Statistics, Biostatistics, Public Health, Health Informatics, Computer Science, Mathematics, or a closely related quantitative field. 

REQUIRED QUALIFICATIONS 

• 4+ years of experience in healthcare data analytics, with a demonstrated track record managing large, complex healthcare databases. 
• Proficiency in SQL, including complex query writing, aggregation, and performance optimization across large relational datasets. 
• Hands-on experience with healthcare claims data across Commercial, Medicare, and Medicaid payer types to include development of healthcare quality metrics.
• Experience with VRDC, CMS data assets, or other government-sourced Medicare/Medicaid datasets. 
• Deep familiarity with US healthcare coding systems: HCPCS, CPT, ICD-10, and DRG. 
• Demonstrated experience developing, validating, and deploying statistical models for healthcare analytics. 
• Excellent written and verbal communication skills; proven ability to present analytical findings to both clinical and non-technical audiences. 
• Advanced analytical, organizational, and problem-solving skills with high personal accountability for work quality. 
• Familiarity with HIPAA and data governance standards applicable to healthcare data environments. 

PREFERRED QUALIFICATIONS 

• Experience working in a Databricks environment, including notebook-based workflows and delta tables. 
• Proficiency in Python, R, and/or SAS for statistical analysis and data processing. 
• Prior exposure to quality measure development frameworks (e.g., NQF, HEDIS, or CMS measure specifications). 
• Familiarity with ETL frameworks and enterprise data warehouse (EDW) environments.