Informaticist, Health Economics

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Job Summary

The Health Economics Informaticist will lead all aspects of building a standardized Medicare data set (membership, premium, medical and pharmacy claims) to support extraction, transformation, and loading, as well as preparation of dashboarding to analyze and report health care data in order to solve complex problems in health economics. The Informaticist works collaboratively with the clinical, operations and healthcare economics teams to recommend a data framework that can be used to build dashboards to support cost/utilization analysis. The Informaticist also serves as an analytics architect and developer of the team’s data warehouse and dashboarding products, and is responsible for standardizing, documenting, and maintaining a data pipeline from ingestion and archiving to outputting information for client project needs.

Essential Duties & Responsibilities

• Design/Maintenance
  • Design and maintain key components of the informatics infrastructure, including terminology, data models, knowledge resources, complex workflows, dynamic end-user interfaces, and aggregations of clinical data (primarily medical and pharmacy claims) designed to support clinical insights.
  • Work collaboratively with external and internal resources to develop claims taxonomy (using grouper logic) to support ingestion of different CMS/Payor data.
  • Recommend and integrate controlled standard terminologies in data normalization and prepare standardized data extracts for research and analysis.

• Project Management:
  • Manage multiple projects simultaneously, ensuring timely delivery of high-quality work products.
  • Collaborate with clinical, operations and finance teams to understand data needs and translate them into actionable project work plans.
  • Identify and structure project-related issues, analyze them, and develop deliverables and recommendations.

• Thought Leadership:
  • Stay up to date with the latest developments in health economics, healthcare policy, and pharmaceutical market trends.

Supervisory Responsibilities

• No supervisory responsibilities.

Education & Experience

• 5-10 years of data science experience focused on medical/pharmacy claims data with detailed knowledge of claims categorization.

• Previous experience with Traditional Medicare and Medicare Advantage.

• Strong database programming skills as well as data preparation and data analysis skills (e.g., SQL, Power BI).

• Demonstrated technical abilities in areas including data-driven applications and developing dashboards.

• Undergraduate degree in Informatics, Business Analytics, Computer Science, Information Systems or equivalent, with an emphasis on healthcare or equivalency.

• Experience with healthcare data warehousing, and data preparation & analysis.

Education Requirements

Education Level

Discipline

Required

Undergraduate Degree

Informatics, Business Analytics, Computer Science, Information Systems

Knowledge, Skills & Proficiencies

• Familiarity with federal data sets from the Centers for Medicare & Medicaid Services and the Bureau of Labor Statistics.

• Proven ability to manage multiple projects and deliver high-quality work within tight deadlines.

• Ability to work independently and as part of a multidisciplinary team.

Physical Requirements

This position works under usual office conditions. The associate is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk, and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by the associate to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Conditions

Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing

Travel Requirements

Amount of Expected Travel

Details

Yes

0-25%

Work might involve some driving/traveling to medical centers.

Tools & Equipment Used

Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

Disclaimer

The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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