Senior Population Health Analytics Consultant

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. 

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

The Senior Population Health Analytics Consultant drives imparts subject matter expertise to support of Value Based relationship aimed at improving Population Health and HEDIS performance. The Senior Population Health Analytics Consultant role collaborates within the department, external partners and cross functionally across the organization. The position will further to the team’s success by establishing leadership presence on clinical quality and would work with the Clinical team to innovate change and drive the teams in advancing quality care. The Senior Population Health Analytics Consultant conducts and participates in activities related to designing, planning, and overseeing initiatives led by the Population Analytics team, which is responsible for the development and implementation of clinical and service quality improvement initiatives. The Consultant understands and helps to execute Population Analytics team objectives, and works in collaboration with internal business and analytical units to define business requirements, and develop analytical end products to support the business objectives. The Consultant must use knowledge of existing business practices, systems, procedures, and policies to provide innovative approaches and solutions to business problems. The Senior Population Health Analytics Consultant will work in in conjunction with the clinical team utilizing data to drive improvement in the value-based programs.

Responsibilities and Qualifications

• Serve as technical point of reference for the following: Value-based reporting; Quality programs; HEDIS technical specifications; Population Health Analytics. Monitors and manages unit workflow by assessing and reporting incoming work and scheduling work responsibilities. Support HEDIS Performance and Plan Performance improvement activities. Support Plan Accreditation. Represent and drive plan performance in Quality and Value-Based programs in Population Health and cross functionally. Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets to assist the Population Health Unit in using clinical data to drive strategy.
• Work with management to develop analytic and/or report requirements that support their ability to make informed decisions regarding strategy initiatives/objectives, and/or appropriate tactical level actions. Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets. Utilizes information gained from research activities to develop positions and recommendations to address healthcare issues and presents research findings, positions and recommendations to management. Ability to quantify and prioritize assigned activities, the ability to adapt to changing priorities, and perform duties with minimal supervision. Includes ability to act both independently and as part of a team. In collaboration with informatics and reporting functional areas and information technology experts, assist in establishing self-service tool requirements that allow for the efficient production of reports and analyses. Develop an understanding of various company information assets to leverage for use in the Population Health Unit activities.
• Translates requirements into production of both ad hoc and recurring reports and data sets. Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations.
• Research and understand industry best practices in payment reform and accountable care organizations pilots/initiatives that are being undertaken by other health plans. Closely monitor CMS developments and regulations in regard to healthcare reform. Co-ordinate work flows with other CBC teams (e.g., PSO, analytic resources) to generate business requirements for reports and to prioritize requests submitted to those groups.

Skills:

• Leadership
• Ability to communicate effectively and professionally, both verbally and in writing with various audiences
• Ability to effectively delegate tasks within the bounds of assigned projects.
• Ability to effectively establish working relationships with individuals of diverse background, knowledge, and all levels of management
• Ability to make low impact decisions not affecting the overall project with guidance and appropriate support.
• Ability to quantify and prioritize assignments and adapt to changing work.
• Skills
• Ability to analyze problems and issues, determine impact, and develop business solutions. Ability to act as a liaison and recommend solutions to a variety of departments, as well as external business partners.
• Ability to plan, organize, lead and control projects and work teams. Includes the ability to effectively communicate in writing and verbally with technical and non-technical audiences.
• Ability to quantify and prioritize assigned activities; ability to adapt to changing priorities; to include the ability to perform duties with minimal supervision. Includes ability to act both independently and as part of a team. Knowledgeable and capable of conducting cost benefit analysis/ROI techniques.
• Ability to lead meetings and give presentations to both management and staff. Includes the ability to develop teamwork among diverse groups. Ability to leverage knowledge and skills to provide consultative solutions to business challenges.
• Knowledge of data processing terminology and concepts. Includes a high level technical understanding of technologies such as Microsoft Office Suite, SAS, SAS Enterprise Guide and Data Modeling. Ability to use technologies to automate processes and monthly reporting. Advanced expertise in SAS, R Studio, Python, Power BI, and Tableau is preferred.
• Ability to develop and implement process flows.
• Ability to leverage knowledge and skills to provide consultative solutions to business challenges.

Knowledge:

• Knowledge of the health care industry. Includes knowledge of standards, policies, and business practices and procedures for multiple departments/systems. Is familiar with those business services, systems and/or processes provided by external business partners.

Experience:

• A comprehensive knowledge of Capital BlueCross data sources is preferred, with some experience using Facets. Minimum 5 years of data analytics experience, 3 years’ experience using SAS and/or SAS Enterprise Guide. Minimum 2 years of experience with analytics platforms like R, python, and/or SQL preferred. Minimum 5 years of experience with data validation and writing business requirements.

Education and Certifications:

• Bachelor's Degree required, preferably in one of the following; business administration, health planning and administration, information systems, data science or computer science.

Work Environment:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must occasionally lift and/or move up to 5 pounds.

Other:

• NCQA quality and accreditation standards

 

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.     And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.