Quality Improvement Data Analyst-FEP
This position contributes to Quality Improvement efforts through the research, analysis, design, programming, implementation and coordination of accurate and timely reporting. The incumbent will partner with multiple customers across the Enterprise to provide complex resolutions to analytics/data problems and will provide reporting/analytic deliverables (i.e. tables, graphs, recommendations, etc.) in a consultative manner. Incumbent is responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. This is a senior level position working independently with guidance only in the most complex situations.
Responsibilities:
Analyzes reporting needs, available data, and various methods of data retrieval to develop systems which are responsive to the needs of the Department.
Develops and maintain production reporting capabilities. Monitor the timely and accurate production and distribution of all standard and special user-generated reports.
Provides statistical and analytical support to the Department staff. Utilizes SAS, SQL, SOURCE and other statistical based software packages to extract and analyze the data required by the Department for both continuing and special needs.
Facilitate business requirements and define parameters of more complex analytic projects
Research and investigate key business problems through quantitative analyses of healthcare cost and quality data.
Analyze data results from multiple information sources to ensure reporting and analytic requirements are met.
Develop forecasting tools using current technology/systems.
Translate business requirements and assist IT with the development of technical specifications.
Lead or participate in internal and external project workgroup(s) and presentations.
Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc.
Prepare materials for internal and external audit activities; review audit findings/reports for accuracy and completeness.
If appropriate, formulate rebuttal and/or corrective action steps. Coach/mentor less experienced staff, assist in on-boarding of new staff and/or distribute and follow-up on work assignments.
Education/Experience:
Bachelor's degree in a Quantitative Field (i.e. Analytics, Economics, mathematics, Computer Science, Engineering, Public Health, Nursing )preferred or relevant work experience in lieu of degree.
Managed Health Care or provider experience preferred, especially in roles that routinely have used clinical data sources to support quality management operations.
3-5yrs experience; conducting complex analytics deliverables (i.e. Linear Models and more advanced independent Analytics).
Knowledge:
Requires proficiency with very large data sets and software/coding (i.e. SAS).
Requires proficiency in MS Office (particularly Excel including formulas, calculations and graphs).
SAS coding knowledge strongly preferred.
HEDIS knowledge strongly preferred
Skills and Abilities:
Requires analytical thinking ability.
Good written and verbal communication skills are essential. Ability to express analytic thoughts clearly and concisely both verbally and in writing (to various audiences) is required. Requires strong interpersonal skills and the ability to interact with all management levels. Require ability to make decisions to analytic/data problems that synthesize information from several sources into concrete actions/recommendations for higher level audience.
Requires the ability to utilize logic in problem solving.
Requires the ability to coordinate projects.
Requires the ability to translate business objectives into technical solutions.
Travel :
Some travel to Newark and Hopewell locations.
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Salary Range:
$86,000 - $117,390
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
Apply Now
Responsibilities:
Analyzes reporting needs, available data, and various methods of data retrieval to develop systems which are responsive to the needs of the Department.
Develops and maintain production reporting capabilities. Monitor the timely and accurate production and distribution of all standard and special user-generated reports.
Provides statistical and analytical support to the Department staff. Utilizes SAS, SQL, SOURCE and other statistical based software packages to extract and analyze the data required by the Department for both continuing and special needs.
Facilitate business requirements and define parameters of more complex analytic projects
Research and investigate key business problems through quantitative analyses of healthcare cost and quality data.
Analyze data results from multiple information sources to ensure reporting and analytic requirements are met.
Develop forecasting tools using current technology/systems.
Translate business requirements and assist IT with the development of technical specifications.
Lead or participate in internal and external project workgroup(s) and presentations.
Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc.
Prepare materials for internal and external audit activities; review audit findings/reports for accuracy and completeness.
If appropriate, formulate rebuttal and/or corrective action steps. Coach/mentor less experienced staff, assist in on-boarding of new staff and/or distribute and follow-up on work assignments.
Education/Experience:
Bachelor's degree in a Quantitative Field (i.e. Analytics, Economics, mathematics, Computer Science, Engineering, Public Health, Nursing )preferred or relevant work experience in lieu of degree.
Managed Health Care or provider experience preferred, especially in roles that routinely have used clinical data sources to support quality management operations.
3-5yrs experience; conducting complex analytics deliverables (i.e. Linear Models and more advanced independent Analytics).
Knowledge:
Requires proficiency with very large data sets and software/coding (i.e. SAS).
Requires proficiency in MS Office (particularly Excel including formulas, calculations and graphs).
SAS coding knowledge strongly preferred.
HEDIS knowledge strongly preferred
Skills and Abilities:
Requires analytical thinking ability.
Good written and verbal communication skills are essential. Ability to express analytic thoughts clearly and concisely both verbally and in writing (to various audiences) is required. Requires strong interpersonal skills and the ability to interact with all management levels. Require ability to make decisions to analytic/data problems that synthesize information from several sources into concrete actions/recommendations for higher level audience.
Requires the ability to utilize logic in problem solving.
Requires the ability to coordinate projects.
Requires the ability to translate business objectives into technical solutions.
Travel :
Some travel to Newark and Hopewell locations.
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Salary Range:
$86,000 - $117,390
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
Apply Now