Location: Baton Rouge, LA
Duration: 6 Months
- This position provides analytics in understanding and improving how health care is valued, utilized and provided.
- This position will develop analytic and/ or predictive attributes that pertain to patient level heal utilization/outcome, provider performance measures, risk-adjustment revenue optimization, medical cost management and behavior attributes on patient/provider engagement.
- In collaboration with otherbusiness areas and IT, this position assists in problem solving, solution development and strategic planning and decision making.
- Accountable for complying benefits, procedures and guidelines, with all laws and regulations associated with duties and responsibilities.
- Requires a Bachelor’s degree in a related field, preferably in health care administration, statistics, economics, mathematics, analytics, computer science, finance, accounting business or other quantitative / health care field.
- Four years of related work experience can be used in lieu of a bachelor’s degree.
- Requires two years of health care, analytics, IT or management consulting experience.
- An advanced degree may substitute for two years of related work experience.
- Must have proficiency with common query/analytic/visualization tools such as SQL, SAS, Access, R, Tableau, etc.
- Strong critical thinking, analytical and problem solving skills are required.
- Prior project management experience 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).
- Experience in data mining, developing predictive models and behavior profiling is highly desirable.
- Knowledge of clinical grouper (HCC, ERG, DCG, and ACG), episode groupers (ETG/MEG/Cave Grouper) and quality metrics (HEDIS, AHRQ) is highly desired.
- Ability to perform multiple projects in a matrix organization.
- Ability to communicate effectively with customers with varying technical/statistical acumen.
- Basic knowledge of United States health care delivery system in payer setting or provider setting is required.
Accountability and Essential Functions:
- Performs scientific and technical planning, analysis, reporting and methodological support to measure and improve population health / risk optimization and provider performances
- Provides ongoing data analysis and recommends focus and direction of resources for decision makers and management that is relevant to the heal care market; assists in problem solving, solution development, decision making, and strategic planning.
- Hypothesizes and develops attributes that characterize or predict health outcome or provider performances.
- Leverages in-house clinical reporting software (Truven, Treo and MDDatacore) to develop attributes on members and providers.
- Translates business rules into analytical models and works as a liaison among health care analytics, EIM, IT and business areas.
- Performs peer data quality reviews, validating data and process to ensure accuracy, completeness, and consistency of department output; recommends process improvements as necessary.
- Investigates existing national and regional data and performs descriptive and analytic studies using basic analytical/statistical techniques.
- Serves as technical expert advisor to collaborating departments on corporate and cross-functional projects, reports, and activities.
Job Specific Duties & Responsibilities:
- Many assignments will involve working collaboratively with different team members within Health Care Analytics organization.
- Developing statistical science-based attributes predicting disease progression, consumer engagement, provider performances using data mining tools such as SAS, R and/or Tableau with additional emphasis on business initiative development and execution.
- Development and governance on predictive attribute (60%)
- Visualization and Dashboard development (20%)
- Business initiative design and evaluation (20%)
- Provider Performance / Population Health Analytics and Risk Optimization
- Development and governance on Member/Provider Attribute (50%)
- Business initiative design and evaluation (i.e., risk optimization) (40%)
- Organizing and prioritizing Health Care Analytics-developed attributes,(i.e., member disease burden attributes, provider performance attributes, etc.) and enable consumption of these insights by non-technical internal business partners through BI-enabled self-service visualizations and dashboards with emphasis on business adoption of the insights.
- The physical demands described here are representative of those that must be met by an employee to successfully perform the accountabilities (essential functions) of the job.
- Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
- Job duties are performed in a normal and clean office environment with normal noise levels.
- Work is predominately done while standing or sitting.
- The ability to comprehend, document, calculate, visualize, and analyze are required.