Principal Bio-Statistical Research Scientist

Explores and operationalizes big data sources using scientific processes and technologies to uncover and communicate product and business insights.

Job Description:

Job Responsibilities

• Developing predictive data models, quantitative analyses and visualization of targeted, big data sources.
• Overseeing the acquisition and ingestion of data from structured and unstructured sources, while ensuring quality and comprehensiveness of data.
• Leading data exploration and analytic projects and providing on-going coaching of big data topics (visualization, data mining, analytic techniques).
• Exploring and implementing semantic data capabilities through NLP, text mining and machine learning techniques.

Job Qualifications

Education

• Undergraduate bachelor’s degree in any discipline with 8 years working experience in managed care/health care claims/ pharmaceutical claims data is required (student jobs do not qualify), OR Master's Degree with 6 years experience, OR Ph.D. with 4 years experience is also acceptable. Quantitative/research discipline preferred but not required (e.g., Biostatistics, Biology, Statistics, Mathematics, Economics, Computer Science, Quantitative Social Sciences, Information Systems).

Experience

• 1 year - Experience with SAS (Base, SQL, Enterprise Miner, Guide) or similar experience with programming and/or statistical analysis required

Skills\Certifications

• Ability to comprehend technical instructions and explain/breakdown problems and issues
• Understanding of planning/design principles and the application of these principles in a planned environment
• Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
• Must be a team player, be organized and have the ability to handle multiple projects
• Excellent oral and written communication skills
• Excellent interpersonal and team building skills
• Working knowledge of statistics and research design

Job Specific Requirements: 

Position Overview:

This position will play a key role in wide-ranging analysis and initiatives related to claims payment, ensuring that processes, data, and benchmarks accurately reflect negotiated provider rates, bundled services, and other related factors. It will involve extensive collaboration with other business areas and external entities as well as direct data analysis.

Preferred Qualifications:

In this role, of the major activities listed above, Utilization and Cost Studies and Network Evaluation will receive greater emphasis than more clinically oriented activities such as Program Evaluation and Outcomes Assessment.

Additional Position Responsibilities: 

• Support of internal reporting/analytics

• Lead governance-related activities

• Mine for data anomalies

• Monitor and maintain data mapping, reference tables and other rules

• Guide development of a dashboard tracking tool or other methods of internal monitoring.

• Perform methodology comparisons, coding review, data validation

• Identify and drive internal improvements

• Track, evaluate, disseminate, and develop action plans on findings and recommendations

• Responsible for plan-specific deep-dive analytics and recommendations  

• Responsible for exploration and assessment of findings from external tools and resources

• Participate in relevant training sessions and share key excerpts internally

• Support for plan-specific logic and “special handling”

• Identify and evaluate best practices

Preferred Skills:

Number of Openings Available:

1

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Remote-First Statement:

BCBST is a remote-first organization with many employees working primarily from their homes.  Each position within the company is classified as either fully remote, partially remote, or office based.

BCBST hires employees for remote positions from across the U.S. with the exception of the following states:  California, Massachusetts, New Hampshire, New Jersey, and New York.  Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense.  If the applicant moves to Chattanooga, TN, they may be eligible for relocation benefits.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities