HIPP Professional Search - Phoenix, AZ

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Health Care & Medical;
Ideal Candidate should be a self-starter and have a good blend of SAS / technical skills, business / health care knowledge, and professionalism.

Job Description
Under the direction of Informatics Management, the Informatics Health Analyst will work to identify, design, recommend, and execute analytical solutions using SAS tools, and provide follow-up consultation services, both of which support medical cost management, provider evaluation, and network development efforts. Position-specific requirements include the following:

  • Analyze healthcare data on a book of business of approximately $1.3 Billion in revenue, with a focus on identifying opportunities for cost/trend management, clinical quality improvement, provider network enhancement, and revenue/profit maximization
  • Identify, develop, and evaluate strategic healthcare quality programs that support as a Qualified Health Plan and the improvement of the overall health of members
  • Ensure that best-in-class industry standards are incorporated and maintained in the design and evaluation of healthcare quality programs, within the defined scope of Informatics responsibility
  • Interpret, communicate, and present results to Directors, Senior Vice Presidents and Executive Vice President in consistent and easy to understand formats to facilitate fact-based decision making
  • Serve as an internal technical & analytic consultant to define business questions and transform data into meaningful and actionable information for a variety of customer segments
  • Deliver business intelligence to clients by applying and demonstrating expertise in the areas of advanced analytics, forecasting, data extrapolation, and predictive modeling
  • Partner with peers to establish, evaluate, and continually improve healthcare measurement methodologies, adhering to nationally accepted analytic and reporting standards (URAC, NCQA/HEDIS, CMS)
  • Build and maintain close working relationships with internal stakeholders (Health Services, Provider Network, Underwriting, Actuarial) and key external client contacts (BCBS Association, Blues Plans, Vendors)
Education & Experience
Bachelor's degree in Bioinformatics, Healthcare Administration, Management Information Systems, Healthcare Information Technology, Statistics, or similar degree, along with 3+ years of related experience is required.

Knowledge & Abilities
  • Proficiency with advanced analytic tools including SAS BI Enterprise, SAS Enterprise Miner, Episode Risk Grouping software, Business Objects, SQL, and Microsoft Office applications
  • Knowledge of healthcare industry, including governing and regulatory agency requirements, plan/benefit design, and fundamental operational principles
  • Knowledge of clinical standards of care, medical terminology and preventive health standards, and the ability to communicate with clinical staff
  • Thorough understanding of statistics, advanced data analytics, data modeling, and reporting methods
  • Ability to independently solve problems and prioritize work assignments in an often ambiguous work environment
  • Ability to communicate complex technical findings to non-technical audiences, both orally and in writing

iCIMS Social Distribution - 2 years ago - save job - copy to clipboard
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