Clinical Data Specialist

Position Summary:
The Clinical Data Specialist serves as a strategic team member identifying, analyzing and interpreting data to drive business outcomes and support clinical services operational outcomes. This role collaborates with intra- and interdepartmental leadership and cross-functional teams to develop actionable insights, optimize operational performance, and ensure compliance with contractual and NCQA requirements. The Specialist plays a critical role in managing high-priority initiatives, delivering data-driven reports, and leading the development of dashboards to support organizational goals. Responsibilities: 

• Research, analyze, and interpret complex data to identify trends, outliers, and opportunities that support organizational decisions, KPIs, and SLAs
• Design and maintain advanced dashboards and reporting solutions that inform strategy, drive decision-making, and monitor program performance. Partnering with data team as appropriate
• Collaborate with cross-functional teams to identify opportunities for improving clinical outcomes and operational efficiency
• Provide actionable recommendations and ensure timely resolution of identified opportunities through detailed documentation and feedback
• Lead cross-departmental initiatives to streamline processes and optimize workflows in alignment with business objectives
• Act as a subject-matter expert in clinical reporting and serve as a key point of contact for internal stakeholders
• Develop and present data visualization and self-service reporting tools to internal departments, empowering stakeholders with actionable insights
• Research and resolve service tickets with a focus on continuous process improvement and adherence to current protocols
• Support the development and implementation of new processes, policies, and tools to enhance clinical reporting and organizational efficiency
• Ensure data accuracy and integrity by overseeing the collection, management, and maintenance of critical information, including member discharge summaries and documentation in Electronic Medical Records (EMR)
• Ensure adherence to HIPAA and other regulatory standards while implementing best practices for data privacy and governance
• Maintain a high level of flexibility to address emerging business priorities
• Perform other duties as assigned

Requirements:

• Bachelor’s degree in Data Analytics, Healthcare Administration, Business or related field
• 3 years of experience in data analysis, clinical reporting, or a related role within a healthcare or business environment
• Strong proficiency in data visualization tools (e.g., Tableau, Power BI) and advanced knowledge of EMR systems
• Demonstrated expertise in operational performance optimization and process improvement
• Strong understanding of regulatory compliance, including HIPAA and other healthcare standards
• Excellent communication, problem-solving, and project management skills

Skills:

• Excellent written and verbal communication, problem-solving, and project management skills
• Proficiency in Microsoft Office: Outlook, Word, PowerPoint
• Strong attention to detail in the completion of deadline driven tasks
• Ability to work collaboratively with data and cross-functional partners
• Strong strategic thinking analytical and organizational skills
• Cooperative and communicative attitude with leadership and team
• Skilled at dealing with confidential information and/or issues using discretion and judgment, independent of direct guidance
• Flexible with the ability to manage and adapt to changing priorities

Travel:No Travel

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