Data Analysis Consultant

Purpose:

The Data Analysis Consultant leads the creation of cutting-edge analytic tools to drive better and faster decision making within the organization and provides critical support for key corporate programs, Medicare Advantage Stars and Risk Adjustment programs as it relates to provider data, provider to claims process. Must have previous Provider data experience working with leadership on provider data issues, accuracy, and provider data interactions with claims and claims platforms. Knowledge of Salesforce and Facets is required. Previous demonstrable experience with reporting to leadership and working remotely with teams is preferred.

Essential Functions:

• 50% Supports enterprise Stars and Risk adjustment strategy through collaboration with analysts, healthcare policy makers, and strategy leaders throughout the company to identify trends and opportunities across the Medicare and Medicaid healthcare landscape. Consults with business leaders, IT partners, and product owners to facilitate product development and guide Stars and Risk Adjustment priorities through insightful analytics.
• 30% Identify and quantify key drivers for the Risk Adjustment and Quality/Stars programs, investigate areas of opportunity, evaluate effectiveness and make recommendations. Apply business knowledge to Analytics projects and provide value-added insights to impact business outcomes, working cooperatively with various internal and external partners. Using the application of sophisticated analytical capabilities, develops and maintains visualizations to support all business divisions across all levels. Develop and maintain scheduled and ad hoc reports for Risk Adjustment and Quality in response to business needs given tight deadlines, minimal direction, and shifting priorities.
• 20% Provide on-going tracking and monitoring of application performance and recommend improvements to methods and algorithms. Work closely with clients, data stewards, and other business and technology leaders to frame problem definition and potential solutions. Required to stay current with Government Programs requirements and directives including those specific to Medicare and Medicaid and update all their reporting and analytics accordingly. Work with external vendors and governmental agencies as required. Excellent organizational skills and ability to set priorities and handle multiple projects concurrently.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Experience: 10 years' experience in data science methodologies, data analysis, modeling and reporting.

Preferred Qualifications:

• Masters or PhD in disciplines identified above
• Experience working with Azure Cloud native programs
• Agile software development experience
• Experience with large data sets and distributed computing (Hive/Hadoop) a plus

Knowledge, Skills and Abilities (KSAs):

• Programming experience with R, SQL, SAS, Python or similar stack, Expert
• Proficiency at transforming data, data classification and translations, as well as resolving data quality and data cleansing challenges, Proficient
• Business knowledge of government programs (Medicare Advantage and Medicaid) healthcare data and systems, Advanced
• Sophisticated analytical capabilities and the development and maintenance of visualizations to support all the business divisions across all level, Advanced
• Intermediate design work and/or use of relational databases including experience working with dimensional modeling, star schemas and time-series data, Advanced
• Demonstrated proficiency with visualization tools such as Power BI Service and Tableau, Proficient
• Experience working with unstructured data such as social determinants of heath, electronic medical records, clinical data, or similar, Advanced

Education Level: Bachelor's Degree

Education Details: Data Science, Mathematics, Computer Science, Statistics, or a closely related field

In Lieu of Education: In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.