Responsible for the deployment and maintenance of statistical models that enhance clinical strategy, operational efficiency, and member experience.
Conduct care management data research and establish data pipelines to support modeling and operational needs.
Explore, research, and analyze business scenarios to identify reductions in health care costs and to better member health management.
Work closely with data stewards and information technology team to design and implement target analytics, integrating multiple data sources, models, and visualization software tools.
Act as a subject matter expert on care management data and build strong working relationships with the Business, Data stewards / IT to advance analytics goals.
Understand business needs, create and document the requirements to support the design and development of standardized and/or ad-hoc reports needed to thoroughly understand the healthcare management opportunities and to support decision making.
Contribute to the development, production, and analysis of detailed statistical models that will support robust healthcare management programs. Includes support in the development of sophisticated risk stratification models to properly identify individuals who will best benefit from active clinical case management.
Communicate findings and recommendations for corrective action and improvement opportunities to senior management and other appropriate stakeholders through dashboard reports, meetings, and presentations, as necessary.
Provide support in the analysis of proposed medical management programs to project the cost and savings from such initiatives.
Provide support for incorporating metrics and benchmarks (both internal and external) to proactively identify and evaluate medical/ clinical processes and programs and impacts to cost, utilization, and quality.
Provide support for ad hoc data mining, reporting, and analytic tasks to help various areas of the company achieve departmental or company goals.