Data Analyst I

Position Description:

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.”

This position will leverage our proprietary dataset and connections to a large set of claims, hospital system, clinical and consumer data to quickly create huge financial and societal benefit, while building a cutting-edge data science skillset on a world-class analytics team. The role is to develop, analyze and validate the business needs of project stakeholders, be they customers or end-users. The Data Analyst will also apply proven communication, analytical, and problem-solving skills to help support the development process, and to ensure that project deliverables are met according to specifications. The role is also to assist in the development quality assurance scripts for assigned projects. The role will develop subject matter expertise that will enhance the requirements, development, analysis and quality phases of assigned projects.

Responsibilities and Qualifications:

• Responsible for the successful delivery of the data & analysis design, development and implementation of machine learning and predictive models on the cost, utilization and quality trends relative to product, program and the communication of this information to key internal and external stakeholders.
• Researches, analyzes, creates and reviews the effectiveness and efficiency of existing and new processes and develops strategies for enhancing or further leveraging these processes.
• Ensures that rigorous research design, comprehensive data collection and sound statistical methods are applied to programs targeted at cost and utilization, population management, care opportunities/care gaps and coding gaps to name a few.
• Assessment and identification of cost and utilization analysis through collaboration with product specialists and data scientists.
• Exhibits comprehensive problem solving skills in a rapidly evolving technical environment.
• Ability to document procedures to run models developed and transfer operational knowledge to the team who will perform operational needs in a production setting.

Skills:

• Be effective at communicating complex structures. Have a high level of interpersonal skills.
• Deep intuition for and experience with predictive modeling (statistics and/or machine learning)
• Technical sophistication with relational and unstructured (big data) database concepts and applications, quantitative methods and related applications and decision support tools.
• Ability to analyze problems, issues, outcomes, determine/estimate/project impact and provide or recommend business solutions.
• 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.
• Demonstrated strong oral, written and presentation skills.

Knowledge:

• SAS. Bonus experience: R, Cognos, Tableau, JavaScript, Python, Ruby, Perl, Linux, Hadoop, Matlab, SQL, knowledge of big data philosophies.
• Experience in Machine Learning (strongly preferred) and Predictive Modeling
• Knowledge of software packages and current database languages. Experience with Data Warehousing and Data Modeling concepts as seen through the mapping developed for changes needed to the data in the Data Warehouse. Knowledge of data in the source systems.
• Bonus experience: Knowledge of insurance and business processes, data, systems, and applications for claim payments, network and provider contract administration and management, population management, EMR, HL7 data knowledge

Experience:

• Minimum of 1-3 years’ experience in health care services research, outcomes research, healthcare economics or epidemiology.
• Experience with quality studies, population based analysis, disease management, and background in research methodologies and statistics.

Education and Certifications:

• The likely background for this role is a MS or PhD in a quantitative, technical discipline (mathematics, statistics, finance, economics or public health), although other backgrounds will be considered.
• Minimum: Bachelor’s Degree in Mathematics, Analytics, Information Systems, or related field

Work Environment:

Ability to provide off-hours assistance to support customers and initiatives. Ability to handle multiple assignments concurrently. Ability to adapt to changing priorities of multiple customers. Ability to work independently and/or as a member of a project team.

Physical Demands:

While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.

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.