Current jobs related to Healthcare Analytics Expert - Harrisburg Pennsylvania - Capital Blue Cross

  • Patent Analyst

    4 weeks ago

    Harrisburg, Pennsylvania, United States Clarivate Analytics Full time

    About the RoleWe are seeking a highly skilled Patent Analyst with expertise in Chemistry, Chemical Engineering, or Biotechnology to join our team at Clarivate Analytics.This is an exciting opportunity to leverage your technical knowledge and experience in patent research and analysis to support our contract with the US Patent & Trademark Office (USPTO).Key...

  • Vice President, R&D Consulting Expert

    4 weeks ago

    Harrisburg, Pennsylvania, United States Clarivate Analytics Full time

    About the RoleWe are seeking a seasoned Vice President to lead our global R&D consulting practice at Clarivate Analytics. As a key member of our Life Sciences Consulting group, you will be responsible for driving the strategy, growth, and financial performance of our R&D Consulting practice.Key ResponsibilitiesManage the R&D consulting profit and loss,...

  • Patent Analyst

    1 week ago

    Harrisburg, Pennsylvania, United States Clarivate Analytics US LLC Full time

    We are seeking a skilled Patent Analyst with a focus in Computing, Electrical Communication, Electronic Engineering, or Physics to support our team at Clarivate Analytics US LLC.This is an exciting opportunity to utilize your technical knowledge by researching and analyzing cutting-edge technologies.As a remote independent contractor, you will be responsible...

  • Director, Pricing Analytics Lead

    2 weeks ago

    Harrisburg, Pennsylvania, United States KPMG Full time

    Job Title: Director, Pricing Analytics Job Summary: KPMG is seeking a Director, Pricing Analytics to join our Growth and Strategy organization. As a key member of our team, you will be responsible for conducting ad-hoc pricing studies and analyses to support long-term growth goals, evaluating opportunities for pricing improvement and competitive price...

  • Analytical Laboratory Manager

    1 week ago

    Harrisburg, Pennsylvania, United States Carlisle Companies Full time

    The Analytical Lab Manager will be responsible for leading a team of Scientists and Technicians in the Research & Innovation Center. They must have a deep understanding of analytical and rheological techniques used in the analysis of formulated polymer products. The techniques should include but are not limited to TGA, DSC, GC, DMA, rheometer, FTIR, MS, GPC,...

  • Director, Pricing Analytics Leader

    3 weeks ago

    Harrisburg, Pennsylvania, United States KPMG Full time

    Job SummaryWe are seeking a highly skilled Director, Pricing Analytics to join our Growth and Strategy organization at KPMG. As a key member of our team, you will be responsible for conducting ad-hoc pricing studies and analyses to support long-term growth goals, evaluating opportunities for pricing improvement and competitive price positioning, and acting...

  • Enterprise IT Expert

    2 months ago

    Harrisburg, Pennsylvania, United States ATC Full time

    Job DescriptionPosition OverviewThe Technical Specialist will serve as the primary technical expert for an enterprise-wide system, providing technical guidance and support to ensure the availability and reliability of the system.Key ResponsibilitiesFunction as the Technical SME on an enterprise-wide system, providing technical expertise to executive...

  • Network Administration Expert

    2 weeks ago

    Harrisburg, Pennsylvania, United States InterSources Full time

    Job Title: Network Administration ExpertJob Summary:We are seeking a highly skilled Network Administration Expert to join our team at InterSources Inc. As a key member of our technical team, you will be responsible for designing, implementing, and maintaining our network infrastructure.Key Responsibilities:Design and implement network architecture and...

  • Senior Analytical Laboratory Manager

    1 week ago

    Harrisburg, Pennsylvania, United States Carlisle Companies Full time

    The Senior Analytical Laboratory Manager will oversee a team of Scientists and Technicians in the Research & Innovation Center, leading the development of new analytical methods and techniques to better understand and predict formulation interactions and long-term performance.Key responsibilities include:Leading a team of Scientists and Technicians in the...

  • Behavior Consultant

    1 week ago

    Harrisburg, Pennsylvania, United States NeurAbilities Healthcare Full time

    Behavior Consultant Job DescriptionAs a Behavior Consultant at NeurAbilities Healthcare, you will play a vital role in helping individuals with autism and other neurodevelopmental disabilities achieve their full potential.Key Responsibilities:Conduct thorough behavior assessments to identify areas of strength and weaknessDevelop and implement personalized...

  • Nurse Expert

    1 month ago

    Harrisburg, Pennsylvania, United States UPMC Full time

    Job SummaryWe are seeking a highly skilled and experienced Nurse Expert to join our team at UPMC. As a Professional Staff Nurse, you will be responsible for providing high-quality patient care and leading our team in delivering exceptional outcomes.About the RoleThe BSN Expert will be responsible for managing and providing patient care activities for a group...

  • Expert ICU Nurse

    1 week ago

    Harrisburg, Pennsylvania, United States UPMC Full time

    At UPMC, we're committed to investing in our nurses – financially, personally, and professionally – from day one of their career.We believe in empowering our nurses to succeed and thrive in their careers, and we're dedicated to providing the support and resources they need to excel.Here's how we support our nurses:Generous Sign-On Bonus of up to $15,000...

  • Software Development Expert

    4 weeks ago

    Harrisburg, Pennsylvania, United States Oracle Full time

    Job DescriptionOracle is seeking a highly skilled Software Development Expert to join our team. As a key member of our software engineering division, you will play a critical role in the definition and evolution of standard practices and procedures.Key Responsibilities:Design, develop, and troubleshoot software programs for databases, applications, tools,...

  • Program Specialist 2- Expert

    1 week ago

    Harrisburg, Pennsylvania, United States Health Advocates Network, Inc. Full time

    Job Summary: We are seeking a highly skilled Program Specialist 2- Expert to join our team at Health Advocates Network, Inc. The ideal candidate will have a strong background in human services, sociology, public health, or a related field, with a minimum of one year of professional experience in developing, implementing, or evaluating programs. The...

  • Senior Product Experience Designer, Analytics

    4 weeks ago

    Harrisburg, Pennsylvania, United States Cardinal Health Full time

    About the RoleWe are seeking a highly skilled Senior Product Experience Designer to join our team at Cardinal Health. As a key member of our Product Experience organization, you will be responsible for defining, leading, and implementing the analytics experience across our Specialty Pharmaceutical Distribution digital product portfolio.Key...

  • Nurse Expert

    4 weeks ago

    Harrisburg, Pennsylvania, United States UPMC Full time

    Job SummaryWe are seeking a highly skilled and experienced Nurse Expert to join our team at UPMC. As a Professional Staff Nurse, you will be responsible for providing high-quality patient care and leading our team with expertise and compassion.About the RoleThe BSN Expert will be responsible for managing and providing patient care activities for a group of...

  • Paid Search Expert

    2 months ago

    Harrisburg, Pennsylvania, United States WebFX Full time

    About the RoleWe are seeking a highly motivated and detail-oriented Digital Marketing Specialist to join our team at WebFX. As a Paid Search Expert, you will play a critical role in driving business growth for our clients through strategic digital marketing campaigns.Key ResponsibilitiesPartner with senior digital marketers to develop and execute...

  • Healthcare Operations Specialist

    2 weeks ago

    Harrisburg, Pennsylvania, United States HonorVet Technologies Full time

    Job Title: Healthcare Operations SpecialistJob Summary: We are seeking a skilled Healthcare Operations Specialist to join our team at HonorVet Technologies. The successful candidate will be responsible for determining and documenting requirements for diagnosis level reporting, following current process and continuously improving data reporting based on...

  • Pharmacist - Pharmacy Expert

    1 month ago

    Harrisburg, Pennsylvania, United States The GIANT Full time

    About The GIANT CompanyWe are a leading grocery retailer committed to making our stores and facilities better every day for our team members, customers, and communities. Our secret recipe for success is built on putting our customers first, doing what's right, winning together, and making ideas happen.Job DescriptionAs a Staff Pharmacist at The GIANT...

  • Clinical Psychologist Expert

    4 weeks ago

    Harrisburg, Pennsylvania, United States Health Advocates Network, Inc. Full time

    Job Title: Psychologist-NDC- ExpertJob Summary:We are seeking a highly skilled Psychologist-NDC- Expert to join our team at Health Advocates Network, Inc. As a key member of our team, you will provide consultation in developing medically based criteria and treatment indicators for reviewing requests for behavioral health services.Responsibilities:Develop and...

Healthcare Analytics Expert

2 months ago

Harrisburg Pennsylvania, United States Capital Blue Cross Full time
Position Overview:

Capital Blue Cross is seeking a highly skilled Clinical Insights Specialist to provide clinical expertise and support to our sales and account management team. This role will involve analyzing data to improve health plan performance and providing insights to inform business decisions.

Key Responsibilities:
  • **Data Analysis**: Coordinate, organize, and facilitate data analysis to support client meetings and business decisions.
  • **Clinical Consultation**: Provide clinical consultation based on analysis and identification of key drivers of results.
  • **Reporting**: Facilitate weekly/monthly clinical and financial status reports for strategic accounts.
  • **Research**: Provide ad hoc clinical summaries and conduct research of claims and relay clinical implications of care rendered for members with likelihood of future healthcare costs.
  • **Relationship Building**: Maintain relationships with employer groups, brokers, and coalitions to support sales efforts.
  • **Collaboration**: Serve as a clinical liaison between the sales team and Information Technology to assist in the design, development, maintenance, training, and evaluation for assigned clinical and business systems or reports.
  • **Leadership**: Lead and promote collaboration across CBC functional areas to support sales and organizational clinical initiatives.
Requirements:
  • **Communication Skills**: Demonstrated excellent oral and written communication skills.
  • **Clinical Knowledge**: Knowledge of current and emerging clinical management practices.
  • **Regulatory Knowledge**: Knowledge of NCQA, JCAHO, and American Accreditation HealthCare Commission/URAC standards.
  • **Regulatory Compliance**: Knowledge of Pennsylvania Department of Health and Department of Insurance regulatory requirements, as well as ERISA and other federal regulations affecting health plan administration.
  • **Research Skills**: Ability to perform thorough research taking into account various product variations.
  • **Analysis Skills**: Ability to perform clinical analysis necessary to translate clinical policies into systems requirements.
  • **Coding Knowledge**: Knowledge of clinical coding, including CPT, HCPCS, ICD-9, Revenue Codes, and DRG's.
  • **Operational Knowledge**: Ability to translate clinical concepts into operational needs that can be coded in a systematic manner.
  • **Data Identification**: Ability to identify data aberrancies which could reflect incorrect methodologies.
  • **Intervention Identification**: Ability to identify interventions that could be taken (such as promotion of cancer screenings, wellness programs, maternity management) based on cost and utilization data.
Experience:
  • **Managed Care Experience**: Minimum of ten years combined experience in a managed care/health insurance environment and clinical setting.
  • **Population Health Experience**: Professional experience with population health data reporting, design, and analysis for health systems.
  • **Clinical Informatics Experience**: Requires clinical practice or clinical informatics related experience that demonstrates an understanding of the tools and concepts used for technical and clinical components of clinical information systems.
  • **BlueCross/Blue Shield Experience**: A minimum of two years' experience with BlueCross/Blue Shield benefit coverage and limitations.
  • **Interrelationship Experience**: A minimum of two years' experience working with interrelationships of benefit coverage.
  • **Managed Care Offerings Experience**: A minimum of two years' experience working with managed care offerings and how benefits are to be interrupted, delivered, and managed.
  • **Medical and Prescription Drug Experience**: A minimum of two years' experience analyzing medical and prescription drug cost and utilization data.
  • **Normative Data Experience**: A minimum of two years' experience working with normative data by product type and industry.
  • **Care Management Documentation Experience**: A minimum of five years' experience working with care management documentation platforms.
Education and Certifications:
  • **Education**: Minimum requirements include an RN degree with active license.
  • **Desirable Education**: Masters degree highly desirable.