Senior Informatics Specialist (Statistician)

WPS Health Solutions Madison , WI 53706

Posted 2 weeks ago

Who We Are

We are a leading not-for-profit health insurer in Wisconsin, and our services have grown to reach active-duty and retired military personnel, seniors, and families in Wisconsin, across the U.S., and around the world. Learn more!

WPS receives World's Most Ethical Company Award for 10th Year in a Row - 2019 Most Ethical Companies Announcement

At Our Core

WPS Health Solutions has earned a reputation as a leader in the insurance and benefits administration industry through our commitment to excellence and high-quality service. Our corporate values reflect the core of who we are and how we conduct business every day.

Customer Focused

I recognize how my actions impact internal and external customers by being responsible for the customer experience. I look beyond the immediate issue to recognize and solve the problem.

Individual Responsibility

I own my actions. I am accountable and dedicated to achieving the best results for WPS Health Solutions and our customers. I embrace my role in helping the company achieve a high-performance workplace.

Mutual Respect

I lead by example and act ethically, honestly and am trustworthy. I show appreciation for others by giving and taking constructive feedback and encouragement.

Driven and Passionate

I approach my work with enthusiasm, and personal commitment to the success of our business. I keep the importance of the work we do for our customers alive in my attitude and interactions with others, and demonstrate pride in the worthiness of our purpose.

Position Summary

The Senior Informatics Specialist will provide statistical, analytical, and data science expertise in creation of advanced analytical and data mining projects. You will design, maintain, and strategize implementation of analytical programs. Build and validate predictive models using a wide variety of statistical and machine learning methods and algorithms. Provide supervision of Insight Data Team.

In this role you will:

Statistical and Data Management (65%)

  • Build and optimize models of complex business problems using machine learning/AI/predictive analytic techniques, including feature selection & engineering, boosting, deep learning, and ensembles.

  • Provide business insights and identify opportunities using statistical, algorithmic, mining, and visualization techniques (including: natural language processing, clustering, segmentation, regression, decision/CART trees, neural networks, time-series analysis, sentiment analysis, topic modeling, random forests, SVM, k-NN, and Bayesian analysis).

  • Select features, build, and optimize classifiers using machine learning techniques.

  • Develop robust testing framework to verify machine learning and predictive model quality and accuracy.

  • Coordinate with operational teams to implement models and monitor key outcomes.

  • Keep abreast of new data science methods and software for advanced analytics.

  • Communicate data findings and insights to operational decision makers, senior level stakeholders, and the wider business. Create visually compelling presentations that simplify communication of complex information and enhance comprehension.

  • Perform statistical sampling and solve related statistical issues in Medicare processes.

  • Develop and maintain methodology in statistical sampling and overpayment extrapolation.

  • Act as Resident Statistician in Medicare Division. Provide statistical expertise and consult with staff in various Medicare departments on statistical issues, explain statistical questions in various reports related to Medicare program. Recommend solutions/best practices.

  • Integrate and prepare large, varied datasets according to data needs. Verify data integrity. Architect specialized database and computing environments.

  • Enhance data collection procedures to include information relevant for building analytic systems; may include extending company's data with additional sources of information.

Supervisory (25%)

  • Provide supervision of InSight Data Team. Manage operational workflows, customer expectations, timelines, and provide mentoring and statistical guidance.

  • Supervise team projects and optimize joint development efforts through appropriate database use, project design, and time and project management. Manage project planning, implementation, and control.

  • Serve as a liaison for joint projects with cross-functional teams.

  • Implement a quality process to assure analytic integrity for team projects.

  • Manage internal and external reporting.

Process Improvement/ Operational Strategy (10%)

  • Leverage in-depth knowledge of business data/systems and understanding of the business process to identify and implement solutions that will result in significant bottom-line contributions and/or efficiency improvements.

  • Assist in prioritizing strategy to reduce Medicare billing aberrancies, fraud and abuse, based on result of data mining.

  • Monitor and safeguard contractor's program integrity, measured by Medicare programs, such as CERT (Comprehensive Error Rate Testing).

You should have:

  • Master's degree in Statistics or related field (Biostatistics, Computer Science, Applied Mathematics), preferably with a strong medical or insurance statistics component
  • 5 or more years of statistical or healthcare analytics experience, to include
  • 2 or more years of experience leading projects and/or teams

In addition, we prefer:

  • Proficient in SAS or R
  • PhD degree in Statistics or related field

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Senior Informatics Specialist (Statistician)

WPS Health Solutions