JOB DESCRIPTION

Sr Health Business Analyst - Care Analytics

The Senior Health Business Analyst within the Commercial Care Analytics team will be accountable for leading a diverse range of analytical projects with a focus on targeting, investigating and quantifying cost and utilization drivers usingclaims, authorization and case management data.

The Senior Health Business Analyst is relied upon to apply business knowledge to Analytics projects and provide value-added insights to directly impact business outcomes. The ideal candidate will have strong technical skills, with a combination of clinically-driven data analytical experience (e.g., knowledge of prevalent conditions in the population, experience with CPT/ICD codes, understands drivers of medical expense, etc.), great communication skills and a natural curiosity to understand health insurance informatics.

The Skills You Bring:

• Act as primary Analyst for assigned projects and proactively identify topics for analysis.
• Analyze claims, authorization and care management program data to identify areas of opportunity and provide analyses, conclusions and recommendations in support of Care business stakeholders.
• Monitor and evaluate patterns, costs and trends as they relate to clinical conditions, member utilization of medical services and care management program outcomes.
• Develop Excel-based models and spreadsheets that are well-documented containing advanced formulas and functions that are used to evaluate historical trends, forecast future expectations or draw key conclusions to answer key business questions.
• Write SAS, SQL, R or Python programs for data extraction and analysis.
• Assist other analysts in training and building knowledge/experience of technical tools, coding languages and data sources.
• Acquire and bring structure to data so that it can be used in existing and new data systems
• Identify, define and translate business needs/problems into analytical questions.
• Design and execute experiments, models, algorithms, and visualizations.
• Train, tune, and evaluate the performance of machine learning models.

Required Skills:

• 4+ years related analytical work experience with a focus in the health or medical industry or equivalent combination of transferable experience and education
• Bachelor's degree required
  Master's degree or equivalent work experience relevant field can be substituted for 2 years' work experience
• Experience with analytics and inferential statistics.
• Intermediate level experience writing SQL /SAS/R or related code
• Advanced Excel skills (ability to create and build pivot tables, formulas, macro automations, etc.)
• Strong mathematical, statistical, and scientific modeling skills
• Experience in predictive analytics, statistical modeling and coding
• Proficiency in SQL and handling large datasets
• Proficiency in R or Python

Preferred Skills:

• Bachelor's degree Business Analytics, Statistics, Data Science, Health Economics or similar program
• Master's degree in a related field
• Working knowledge of clinical conditions, procedure codes (CPT-4, HCPCs), diagnosis codes (ICD-10), and
• Experience evaluating ROI and financial impact of care and disease management programs
• Experience with any of the following libraries: caret, tidyverse, data.table, scikit-learn, pandas, NumPy
• Experience using version control (Git) for program development