Business Systems Analyst: Hoag Clinic Claims & Enrollment

About the job

Job Description The Business Systems Analyst plays a critical role in supporting advanced analytics and data driven decision making across Hoag Clinic operational departments, including but not limited to Member Services, Quality, Utilization Management, Claims, Medical Management, Clinical Services, and Eligibility.

This role is responsible for designing developing and maintaining complex analytical solutions including Power BI dashboards enterprise reports and scalable data models. The analyst will work extensively with Power Query and SQL to extract transform and model data from multiple source systems and will be expected to independently translate complex business questions into actionable insights.

The ideal candidate has strong hands-on experience with Power BI, Power Query and SQL and is comfortable working with large healthcare datasets end to end from data ingestion and transformation through visualization and presentation.

Responsibilities Primary Duties and Responsibilities

• Design develop and maintain advanced Power BI dashboards semantic models and reports used by operational and clinical leadership
• Use Power Query extensively to extract transform cleanse and combine data from multiple source systems
• Write optimize and maintain complex SQL queries views and datasets to support reporting and analytics
• Partner with business stakeholders to translate operational and regulatory requirements into scalable analytical solutions
• Perform deep dive analysis across claims referrals eligibility and utilization data to identify trends anomalies and operational risks
• Ensure data accuracy consistency and integrity across all reporting layers including source transformation and visualization
• Collaborate with IT Strategic Analytics and external partners to improve data pipelines data availability and performance
• Create and maintain documentation for data sources transformations calculations business rules and reporting definitions
• Serve as a subject matter expert for Power BI Power Query and SQL within the department
• Stay current on Power BI feature releases advanced modeling techniques and healthcare analytics best practices
• Perform other duties as assigned

Qualifications

Education and Experience

• Bachelor’s degree in Data Analytics Information Systems Business or equivalent practical experience
• 3 plus years of hands-on experience in data analytics business intelligence or reporting roles
• Strong hands-on experience using Power BI including Power Query data modeling DAX and visualization best practices
• Strong SQL skills with experience querying and transforming complex relational datasets
• Experience working with healthcare data including claims referrals eligibility or utilization highly preferred
• Solid understanding of data warehousing concepts star schema and reporting optimization
• Proven ability to independently manage multiple analytics deliverables from requirements through delivery
• Strong analytical critical thinking and problem-solving skills
• Excellent communication skills with the ability to present data insights to non-technical audiences

About Us

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ .

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.