Senior Clinical & Population Health Analyst

Company :

Highmark Health

Job Description : 

JOB SUMMARY

This job creates data-driven insights which identify actionable opportunities and/or create analytics and reporting solutions aligned to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care delivery. The incumbent serves as a consultative subject matter and technical expert for internal and external customers, leveraging advanced analytical expertise and experience to aggregate, analyze and understand patterns in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities.

ESSENTIAL RESPONSIBILITIES

• Supports and leads the design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical, member, financial and administrative data to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to successful completion.

• Establishes strong, collaborative and effective relationships and communication with internal and external clinical, administrative, operational, financial and technical stakeholders to ensure analytics are actionable and aligned with organizational strategic priorities, needs, plans and resources.

• Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought leadership and subject matter expertise.

• Provides consultative, technical, subject matter and business expertise mentorship to colleagues across the enterprise.

• Other duties as assigned or requested.

EDUCATION
Required

• Bachelor's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or closely related field

Substitutions

• None

Preferred

• Bachelor’s degree or background in actuarial science or statistics

EXPERIENCE
Required

• 5 years of leading the design, execution and dissemination of clinical and population health reporting, analyses and studies of progressive scope and complexity

• 5 years with coding languages, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data

• 3 years of project leadership in a complex, matrixed environment (payer and/or provider preferred)

• 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders

Preferred

• Advanced programming skills in SAS including writing macros

• Other programming skills preferred Python, R, Alteryx, SQL

• Extensive experience working in a population health environment and familiarity with HEDIS measures

• Experience with building dashboard in tableau and other visualization tools like R studio, Power- BI.

LICENSES or CERTIFICATIONS
Required

• None

Preferred

• None

SKILLS

• Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about clinical care and population health that drive the Quadruple Aim

• Strong working knowledge of coding languages, relational databases, quantitative and qualitative analytic methodologies, advanced analytics and statistics

• Excellent communication and facilitation skills with project team members, stakeholders, executives, and external customer, exceptional written and oral presentation skills, proven ability to communicate interpersonally and technically with technical and non-technical, and internal and external audiences, and the ability to lead through influence

• Healthcare industry expertise and experience, knowledge about the shifting healthcare environment including trends concerning health insurance, healthcare delivery, provider relationships and regulatory issues

• Sophisticated knowledge of how organizations work and how to get things done through formal and informal channels

• Exhibition of perseverance through energy, drive and demonstrated success when resistance or setbacks are encountered

• In-depth understanding of and experience with both clinical and business processes, and the ability to identify opportunities for improvement and develop solutions

• Demonstrated ability to informally lead matrixed t