Senior Clinical Analyst - Newark, United States - Horizon Blue Cross Blue Shield of New Jersey

Description

Job Description

Job Description

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.


Responsibilities:

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.

Navigates across multiple analytical and business units to socialize and gain buy-in for analysis design, results and interpretation, including making recommendations on how to use the results to inform business decisions.

Ensures appropriate use of analytic tools and programming techniques for analytics and reporting efficiency.

Builds quality assurance criteria to ensure data and analytics results accuracy and consistency.

Documents methods, specifications and findings clearly. Contributes to writing and presentation of results, findings and conclusions to management and leadership.

Collaborate with team members to document work appropriately, including SAS coding comments and use of analytic plan/timeline where needed for analytic projects.

Disclaimer:

This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification.

It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Additional Job Description Additional Job Description

Education/Experience:

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.

Requires extensive knowledge of US healthcare industry, health plan business, claims data, clinical data, and coding practices.

Requires proficiency with MS Excel for data analysis and reporting.

Solid organizational skills and attention to details.

Strong ability to work in a fast-paced team-oriented environment.

Strong ability to manage competing priorities.

Highly motivated and able to work independently.

Company Description Horizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.

We are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).

Company Description

Horizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.\r

We are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).

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