Expert Data

3 weeks ago

Southfield, United States Blue Cross Blue Shield of Michigan Full time

The Expert Data & Analytic Analyst - Stars leverages statistical methodologies to draw insightful conclusions from complex healthcare data, supporting the improvement of strategic decision-making for Medicare Stars. This role demands mastery of statistical inference, proficiency in data analysis tools, and close collaboration with diverse stakeholders to translate data into actionable insights.

RESPONSIBILITIES:

Drive Evidence-Based Medicare Stars Optimization:

Design and execute rigorous statistical studies to assess program effectiveness, measure performance against Stars criteria, and identify areas for improvement.

Utilize advanced statistical models (e.g., regression analysis, mixed models) to analyze HEDIS, CAHPS, HOS, Pharmacy, and Operations data to identify factors influencing star ratings.

Effectively communicate results through concise reports and presentations, translating complex statistical concepts into actionable recommendations for Star rating improvement.

Deep Dive into Data-Driven Problem Solving:

Conduct root cause analyses using advanced statistical techniques to diagnose operational issues impacting Stars performance.

Develop statistical models to assess the potential impact of program interventions, monitor their effectiveness through ongoing analysis, and refine strategies based on findings.

Expertise in Statistical Analysis and Tools:

Possess a comprehensive understanding of statistical inference principles, hypothesis testing, and various statistical tests.

Proficiently utilize statistical analysis tools and languages like Python, R, SQL, SAS, and statistical software packages.

Develop and maintain data pipelines for efficient data access and analysis.

Collaboration and Communication:

Partner closely with domain experts and stakeholders to define data needs, analyze results, and communicate insights effectively to all levels of the organization.

Create clear and compelling reports and presentations, tailoring communication to diverse audiences.

Continuous Learning and Professional Growth:

Stay informed about the evolving healthcare landscape and advancements in CMS Star Rating.

Pursue opportunities for professional development and certification in relevant data science disciplines.

EDUCATION:

Master's degree in Statistics, Public Health, Data Science, or a related field preferred. Bachelor's degree in a quantitative field required.

EXPERIENCE:

Two (2) to four (4) years of experience using Research/data analysis methods to solve complex problems in healthcare or related fields is required. 5 years of experience is preferred. Demonstrated experience with the healthcare payer or provider data (ICD codes, CPT code) and relevant performance measures.

SKILLS AND KNOWLEDGE:

Mastery of statistical inference principles, hypothesis testing, and various statistical tests.

Proficiency in statistical analysis tools and languages (SAS, Python, R, SQL, etc.).

Experience with common data analysis software (Excel, Tableau, Power BI, etc.)

Strong analytical, project management, problem-solving, and communication skills.

Experience with data mining, modeling, and visualization techniques.

Ability to work independently and collaboratively in a fast-paced environment.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

Pay Range

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $70,400 and $117,800.

We are an Equal Opportunity Employer.

Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis.

Nothing herein is intended to create a contract.

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