8 days old

Statistical Data Insight Analyst

Independence Blue Cross LLC
Philadelphia, PA 19107
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Bring your drive for excellence, team orientation and customer commitment to Independence; help us renew and reimagine our business and shape the future of health care. Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team. If this describes you, we want to speak with you.

The Statistical Data Insight Analyst reports to the Manager, Risk Analytics of Government Markets and is responsible for quantitative and qualitative data analysis and reporting of patterns, insights, trends, and providing recommendations to decision makers. Collects, aggregates and analyzes data from multiple internal and external sources to drive insights. Produces actional reports that show key performance indicators, identifies areas of improvement, and display root cause analysis of problems. Uses analytics and metrics to improve processes and provide data-driven forecasts of potential opportunities, costs, and risks.

Key responsibilities of this role include:

  • Works with Government Markets (GM) Data Sets and CMS Data Sets to produce analyses and reports. Data Sets include, but are not limited to, member enrollment, eligibility, risk adjustment, pharmacy, and medical claim data. Provider and network data, and vendor supplemental data. CMS data to be analyzed includes PDE, Part D, MMR, MOR, TRR, Risk Adjustment, PWF and other CMS files as needed.

  • Works with data sets to assure accuracy and integrity of data and reports.

  • Provides qualitative analysis on risk and financial data sets and reports, including cost/benefit analysis, ROI analysis, and payment data/reporting accuracy for both internal and external vendor payments.

  • Evaluates, plans, designs, manages project timelines for most complex projects assigned by management.

  • Assesses business requirements and implements appropriate solutions.

  • Provides recommendations for data gathering.

  • Designs tracking and trending analyses for department processes.

  • Evaluates business outcomes and monitors work solutions.

  • Works with technical staff and provides input to system changes and enhancements that may affect workflow.

  • Designs and evaluates pre and post workflows and processes.

  • Develops desk procedures including work procedure manuals and updates as needed. Assures that new procedures are implemented and understood by staff and external departments that may be affected.

  • Assists in responding to most complex special requests from management that feature research, investigation, evaluation, documentation and presentation of findings.

  • Ensure sound analytical methods.

  • Bachelor's degree in Business Administration, Mathematics, Statistics, related field or equivalent work experience that provides knowledge of and exposure to fundamental theories, principles, and practices.

  • Minimum 3-5 years related experience.

  • Demonstrated proficiency in statistical modeling

  • Knowledge in one or multiple of the following: Medicare, ACA, CMS, Risk Adjustment or Part D

  • Knowledge of compliance and audit practices, specifically those related to Medicare Payment and Reimbursements to Plans

  • Demonstrated ability to define business solutions, make decisions, identify problems, coordinate resources, and implement changes.

  • Strong oral and written communication skills.

  • Must be able to work independently on projects, demonstrate effective leadership skills and follow through on project life cycle while maintaining target deadlines.

  • Must be detailed oriented and have strong analytical and problem-solving skills.

  • Ability to work in a multi-task environment.

  • Strong technical knowledge of Microsoft office products.

  • Experience with R required (2+ years preferred)

  • Experience creating, maintaining, and developing R/Shiny applications.

  • Experience with Tableau

  • Proficient with SQL and has a sound understanding of relational databases

Jobs Rated Reports for Statistician

Posted: 2021-06-08 Expires: 2021-07-07
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Statistical Data Insight Analyst

Independence Blue Cross LLC
Philadelphia, PA 19107

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2nd2019 - Statistician
Overall Rating: 2/199
Median Salary: $84,760

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