- Provides analytical insights to support business solution development based on quality, use, cost and other key drivers
- Develops and refines analysis templates for problem diagnosis and opportunities assessment
- Consults on all considerations related to designing and executing tests or pilot programs
- Contributes to the design of new program/initiative based on test/pilot outcomes
- Develops targeting criteria or customer segmentation based on analytical insights
- Develops predictive models and other tools that help target the right members
- Develops methodology to measure clinical, utilization and financial outcomes
- Conducts in-depth research to address challenging issues in measuring outcomes
- Leads applied research projects; authors white papers, presents at industry conferences and submits journal publications
- Addresses limitation of certain data sources and evaluates incremental value of new data sources
- Managing custom ASO client business definitions thru Rule committee approval, intake submission, and implementation on rules engine
- Produce custom financial models for ASO clients to support impact analysis of operational errors and potential refunds
- Support multiple new strategic projects such as Agora, NCPDP F6, AI BI, etc
Requirements
- Requires MS, MA, or PhD with concentration in a quantitative discipline such as Mathematics, Statistics, Economics, Epidemiology, Engineering, Computer Science or Operations Research
- Minimum of 5 years experience in related health care analytics
- PhD preferred
- Experience with developing expert modeling system for segmentation/stratification
- Substantial analytical experience in healthcare industry preferred
- Advanced expertise with Databricks or equivalent analytical tools
- Comprehensive experience with Teradata, SQL, or equivalent database tools strongly preferred
Core Competencies
Demonstrates advanced analytical capabilities in healthcare analytics, including the development of predictive models and financial analysis. Proficient in utilizing tools like Databricks and SQL to derive insights and support strategic projects.
Highest-signal resume keywords
- Healthcare Analytics Experience
- Predictive Modeling Development
- Advanced Databricks Expertise
- SQL Database Proficiency
- PhD in Quantitative Discipline
ATS Optimization Keywords
Hard Skills
- Predictive Modeling
- Statistical Analysis
- Data Segmentation
- Financial Modeling
- Research Methodology
Soft Skills
- Analytical Thinking
- Problem Solving
- Communication Skills
Industry Keywords
- Healthcare Industry
- ASO Client Management
- Outcome Measurement
- Utilization Analysis
- Epidemiology
Tools & Technologies
- Databricks
- Teradata
- SQL