Clinical Analytics Analyst III

Horizon BCBS NJ is the #1 Rated Managed Care Company in NJ.

We are continuing to grow our Value Based Analytics Team. Please consider joining the leader in healthcare! We have stability and continued growth. We offer excellent team growth and an extremely competitve over-all compensation package.

The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member collaborating in a multi-disciplinary business environment with colleagues across the enterprise to lead clinical performance analytics, development, and reporting that deliver actionable clinical insights to providers and health care value to members and employer customers.

As a subject matter expert, the role collects business requirements, translates business requirements into analytics design, define data & analytics specifications, manipulates and analyze large healthcare data from various data sources, and interpret the findings to inform opportunities and solutions that improve clinical quality and increase cost efficiency and health care affordability. This position requires sound data analytic programming skills with robust knowledge and understanding of the healthcare business and data.

• Acts as the analytic lead for complex clinical analytics projects involving multiple data resources and teams to inform business decisions in clinical, network, value-based payment models, and employer engagement.
• Understands the strategic direction of the organization and the analytic and reporting requirements to meet departmental needs. Translates business questions and needs into analytics technical requirements including data analytics design, clinical and data specifications, and reporting format.
• Leads the design and extraction of data from multiple sources. Creates integrated analytic datasets. Performs analytics and summarizes findings to inform business opportunities and address business questions.
• Provides insight and guidance into analytic findings (including root causes and contributing factors – both actionable and not) through clear, professional, succinct written and oral summaries, tables, charts, reports, or presentations.

Education/Experieince:

• Bachelor degree in Math, Statistics, Data Science, Economics, Epidemiology, Public Health, or related field preferred or relevant experience in lieu of degree.
• Prefers a master’s degree in Math, Statistics, Data Science, Economics, Epidemiology, Public Health, or related field.
• Requires a minimum of 7 years of experience in Data Analytics, Informatics, Medical Economics or other relevant work experience.
• Requires a minimum of 7 years of experience performing analysis on large healthcare administrative claims data, EHR/EMR data, or complex relational health care databases with significant experience analyzing medical, pharmacy, and behavioral health claims data.
• Requires a minimum of 7 years of hands-on programming experience using SAS/SQL.
• Requires extensive knowledge of US healthcare industry, health plans.