Senior Population Health Analytics Consultant

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. 

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

The Senior Population Health Analytics Consultant drives imparts subject matter expertise to support of Value Based relationship aimed at improving Population Health and HEDIS performance. The Senior Population Health Analytics Consultant role collaborates within the department, external partners and cross functionally across the organization. The position will further to the team’s success by establishing leadership presence on clinical quality and would work with the Clinical team to innovate change and drive the teams in advancing quality care. The Senior Population Health Analytics Consultant conducts and participates in activities related to designing, planning, and overseeing initiatives led by the Population Analytics team, which is responsible for the development and implementation of clinical and service quality improvement initiatives. The Consultant understands and helps to execute Population Analytics team objectives, and works in collaboration with internal business and analytical units to define business requirements, and develop analytical end products to support the business objectives. The Consultant must use knowledge of existing business practices, systems, procedures, and policies to provide innovative approaches and solutions to business problems. The Senior Population Health Analytics Consultant will work in in conjunction with the clinical team utilizing data to drive improvement in the value-based programs.

Responsibilities and Qualifications

• Serve as technical point of reference for the following: Value-based reporting; Quality programs; HEDIS technical specifications; Population Health Analytics. Monitors and manages unit workflow by assessing and reporting incoming work and scheduling work responsibilities. Support HEDIS Performance and Plan Performance improvement activities. Support Plan Accreditation. Represent and drive plan performance in Quality and Value-Based programs in Population Health and cross functionally. Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets to assist the Population Health Unit in using clinical data to drive strategy.
• Work with management to develop analytic and/or report requirements that support their ability to make informed decisions regarding strategy initiatives/objectives, and/or appropriate tactical level actions. Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets. Utilizes information gained from research activities to develop positions and recommendations to address healthcare issues and presents research findings, positions and recommendations to management. Ability to quantify and prioritize assigned activities, the ability to adapt to changing priorities, and perform duties with minimal supervision. Includes ability to act both independently and as part of a team. In collaboration with informatics and reporting functional areas and information technology experts, assist in establishing self-service tool requirements that allow for the efficient production of reports and analyses. Develop an understanding of various company information assets to leverage for use in the Population Health Unit activities.
• Translates requirements into production of both ad hoc and recurring reports and data sets. Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations.
• Research and understand industry best practices in payment reform and accountable care organizations pilots/initiatives that are being undertaken by other health plans. Closely monitor CMS developments and regulations in regard to healthcare reform. Co-ordinate work flows with other CBC teams (e.g., PSO, analytic resources) to generate business requirements for reports and to prioritize requests submitted to those groups.

Skills: