Senior Healthcare Informatics Analyst
Blue Cross and Blue Shield of Louisiana
full-time
Posted on:
Location Type: Remote
Location: Louisiana • United States
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Job Level
About the role
- Independently provides analytics in understanding and improving how health care is valued, utilized and provided.
- Develop analytic attributes that pertain to patient level health utilization/outcome, provider performance measures, risk-adjusted revenue optimization, medical cost management, and behavior attributes on patient/provider engagement.
- In collaboration with other business areas and IT, leads in problem solving, solution development and strategic planning and decision making.
- Accountable for complying with all laws and regulations associated with duties and responsibilities.
- Leads the selection of evaluation/analytics/BI methodologies and communicate recommendations to facilitate problem solving, solution development, decision making and strategic planning.
- Appropriately leverages in-house clinical reporting software and models, Enterprise Data Warehouse (EDW) data sources and non-EDW data sources.
- Independently facilitates business development and documents business problems and develops analytic solutions (i.e. Predictive model, BI solution, or analytic attributes).
- Serves as the analytics advisor to collaborating departments on corporate and cross-functional projects, reports and activities.
- Independently translates business rules into analytical models and works as a liaison among healthcare analytics, Enterprise Information Management (EIM), IT and business areas.
- Performs peer data quality reviews, validating data and process to ensure accuracy, completeness and consistency of department output.
- Independently performs descriptive and analytic studies using advanced analytical/statistical techniques.
Requirements
- Bachelor's in healthcare administration, statistics, economics, analytics, computer science required
- Master's in related field preferred
- 4 years of health care, analytics, IT or management consulting experience.
- Experience building predictive models.
- Advanced knowledge of SAS including Enterprise Miner is preferred.
- Basic knowledge of United States healthcare delivery system in payer setting or provider setting is required.
- Strong knowledge of common query/analytic/visualization tools such as SQL, SAS, R, Python, Tableau, etc.
- Strong understanding of provider payment methodologies, population health management, and risk adjustments is desired.
- Strong understanding of clinical groupers including episode groupers and risk groupers such as DRG, APC, ETG, MEG, DxCg, and HCC is highly desired.
- Strong understanding of quality metrics (HEDIS, AHRQ) is desired.
- Knowledge of commercial risk optimization and MA risk optimization is a plus.
- Excellent verbal and written communication skills; strong interpersonal skills.
- Ability to analyze, consolidate and communicate complex technical topics to all levels of internal staff and external vendors (including but not limited to executives, business and technical managers, developers and system administrators).
Benefits
- We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
predictive modelsSASSQLRPythonTableauadvanced analytical techniquesdata quality validationdescriptive studiesstatistical techniques
Soft Skills
verbal communicationwritten communicationinterpersonal skillsproblem solvingsolution developmentstrategic planningdecision makingcollaborationanalytical thinkingbusiness development
Certifications
Bachelor's in healthcare administrationBachelor's in statisticsBachelor's in economicsBachelor's in analyticsBachelor's in computer scienceMaster's in related field