Clinical Analytics Analyst - IV

September 24

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NJM Insurance Group

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Auto Insurance • Workers'​ Compensation Insurance • Homeowners Insurance • Commercial Auto Insurance • Renters Insurance

1001 - 5000

Description

• Acts as the analytic lead for complex clinical analytics projects involving multiple data resources and teams to inform business decisions in clinical, network, value-based payment models, and employer engagement. • Understands the strategic direction of the organization and the analytic and reporting requirements to meet departmental needs. • Translates business questions and needs into analytics technical requirements including data analytics design, clinical and data specifications, and reporting format. • Leads the design and extraction of data from multiple sources. • Creates integrated analytic datasets. • Performs analytics and summarizes findings to inform business opportunities and address business questions. • Provides insight and guidance into analytic findings (including root causes and contributing factors – both actionable and not) through clear, professional, succinct written and oral summaries, tables, charts, reports, or presentations. • Navigates across multiple analytical and business units to socialize and gain buy-in for analytics design, results and interpretation, including making recommendations on how to use the results to inform business decisions. • Ensures appropriate use of analytic tools and programming techniques for analytics efficiency. • Builds quality assurance criteria and processes to ensure data and analytics results accuracy and consistency. • Documents methods, specifications and findings clearly. • Collaborate with team members to document work appropriately, including SAS coding comments and use of analytic plan/timeline where needed for analytic projects. • Present analytics findings to internal leadership teams and external provider partners to inform actionable opportunities and solutions. • Provide technical trainings (analytics design, data, programming, QA, statistics, documentation, etc.) to junior analysts.

Requirements

• High School Diploma/GED required. • Bachelor degree in Math, Statistics, Data Science, Economics, Epidemiology, Public Health, or related field preferred or relevant experience in lieu of degree. • Prefers a Master degree in Math, Statistics, Data Science, Economics, Epidemiology, Public Health, or related field. • Requires a minimum of 10 years of experience in Data Analytics, Informatics, Medical Economics or other relevant work experience. • Requires a minimum of 10 years of experience performing analysis on large healthcare administrative claims data, EHR/EMR data, or complex relational health care databases with significant experience analyzing medical, pharmacy, and behavioral health claims data. • Requires a minimum of 10 years of hands-on programming experience using SAS. • Requires extensive knowledge of US healthcare industry, health plan business, claims data, clinical data, and coding practices. • Requires proficiency with MS Excel for data analysis and reporting. • Requires solid organizational skills and attention to details. • Requires strong ability to work in a fast-paced team-oriented environment and strong ability to manage competing priorities. • Must be highly motivated and able to work independently. • Prefers knowledge and working experience of visualization and BI tools (e.g., Tableau, Power BI.) with preference given to Tableau experience. • Prefers hands-on experience of clinical episode groupers and analytics, preferably with Optum’s Symmetry Suite of Services (Impact Intelligence, ImpactPro, ETG, ERG, PEG, EBM, PRG, etc.) or PROMETHEUS. • Prefers knowledge and direct experience of Milliman’s analytics tools such as MedInsight Health Cost Guidelines (HCG) Grouper, Milliman Advanced Risk Adjusters (MARA), MedInsight Benchmarks. • Prefers knowledge and experience of statistical tests and predictive modeling.

Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement