Blue Cross and Blue Shield of Louisiana Senior Healthcare Informatics Analyst in Baton Rouge, Louisiana
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
The Senior Healthcare Informatics Analyst independently provides analytics in understanding and improving how health care is valued, utilized and provided. This position will develop analytic attributes that pertain to patient level health utilization/outcome, provider performance measures, risk-adjusted revenue optimization, medical cost management, and behavior attributes on patient/provider engagement. In collaboration with other business areas and IT, this position leads in problem solving, solution development and strategic planning and decision making.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
NATURE AND SCOPE
This role does not manage people
Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with the following: Clinical Solutions, Clinical Partnerships, Actuary, Provider Reimbursement, and Actuarial, Payment Innovation, IT, Marketing, external vendors, Blue Cross Blue Shield Association and other plan BCBS plan partners.
Bachelors in healthcare administration, statistics, economics, analytics, computer science
Masters in related field preferred
Four years of related experience can be used in lieu of a Bachelor’s degree.
- 4 years of health care, analytics, IT or management consulting experience. A master’s degree may substitute for two years of the total four years required. A doctorate degree may be substituted for an additional two years of related work experience.
Skills and Abilities
Strong critical thinking, analytical and problem-solving skills are required.
Requires experience building predictive models.
Strong knowledge of outcome research design, controlled study design is preferred.
Advanced knowledge of SAS including Enterprise Miner is preferred.
Basic knowledge of United States healthcare delivery system in payer setting or provider setting is required.
Must have strong knowledge of common query/analytic/visualization tools such as SQL, SAS, R, Python, Tableau, etc.
Strong understanding of provider payment methodologies, population health management, and risk adjustments is desired.
Strong understanding of clinical groupers including episode groupers and risk groupers such as DRG, APC, ETG, MEG, DxCg, and HCC is highly desired. Strong understanding of quality metrics (HEDIS, AHRQ) is desired.
Knowledge of commercial risk optimization and MA risk optimization 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).
Licenses and Certifications
- None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Leads the selection of evaluation/analytics/BI methodologies and communicate recommendations to facilitate problem solving, solution development, decision making and strategic planning.
Appropriately leverages in-house clinical reporting software and models, Enterprise Data Warehouse (EDW) data sources and non-EDW data sources.
Independently facilitates business development and documents business problems and develops analytic solutions (i.e. Predictive model, BI solution, or analytic attributes).
Serves as the analytics advisor to collaborating departments on corporate and cross-functional projects, reports and activities.
Independently translates business rules into analytical models and works as a liaison among healthcare analytics, Enterprise Information Management (EIM), IT and business areas.
Performs peer data quality reviews, validating data and process to ensure accuracy, completeness and consistency of department output.
Independently performs descriptive and analytic studies using advanced analytical/statistical techniques.
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and 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.
An Equal Opportunity Employer
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Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
JOB CATEGORY: Data Analytics/Warehousing, & Business Intelligence
Blue Cross and Blue Shield of Louisiana
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