Health Services Researcher (Data Scientist)

<strong>With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.</strong>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

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Competitive Total Compensation Package

Overview: <div><strong><span style="font-size: small;">DEPARTMENT SUMMARY:</span></strong></div> <div><span style="font-size: small;"><br />Independently leads health research projects by performing conceptualization, design, execution, and interpretation of novel BCBSM fee-for-value and risk-based initiatives.&nbsp; Partners with Health Care Value, Health Plan Business, and Emerging Markets staff to provide well-defined, accurate, and timely analyses that answer client questions; drives the completion of these analyses through project management of other HCVA&amp;I staff..., Monitors existing programs, and leverages evidence based analyses to guide decision making across various health insurance products.&nbsp; &nbsp;&nbsp;Provides leadership that yield quantitative collaborations to enhance health care value.</span></div>
Responsibilities: <div> <ol> <li> <div><span style="font-size: small;">Independently performs risk adjustment, case definition, generation of data visualization dashboards, and ad hoc analyses. Supports clinical metrics development, methods development, incentive recommendations under the counsel of a senior&nbsp;Program Development &amp; Analytics&nbsp;staff member. Executes implementation of research questions on defined data sources.&nbsp;</span></div> </li> <li> <div><span style="font-size: small;">Serves as lead for defined projects, and executes project management with other HCVA&amp;I staff.&nbsp; Responsible for providing high quality, accurate, and timely project deliverables.</span></div> </li> <li> <div><span style="font-size: small;">Supports strategic discussions with&nbsp;PDA Leadership and leadership across HCV and BCBSM by providing model results derived from BCBSM data marts and registries.</span></div> </li> <li> <div><span style="font-size: small;">Designs and implements straightforward research projects to understand the disease burden in BCBSM insured population and health care services being utilized for disease diagnosis and treatment.&nbsp; Assists in working cross-functionally to obtain clinical and operational input.&nbsp;</span></div> </li> <li> <div><span style="font-size: small;">Interprets and presents results to a variety of quantitative and non-quantitative audiences.</span></div> </li> <li> <div><span style="font-size: small;">Defines programming specifications for analyses and validates the programming of other HCVA&amp;I staff.&nbsp; Performs primary programming for exploratory data analysis.</span></div> </li> </ol> </div> <ul> <li><span style="font-size: small;"><strong>Involved in advanced analytics in support of conceptualization, design and evaluation of BCBSM clinical programs, such as the largest Patient-Centered-Medical Home initiative in the nation and numerous pay-for-performance initiatives.</strong></span></li> <li><span style="font-size: small;">Design and implement epidemiologic studies to understand disease burden in BCBSM insured population and health care services being utilized for disease diagnosis and treatment.&nbsp; </span></li> <li><span style="font-size: small;">Identify opportunities for clinical programs.&nbsp; </span></li> <li><span style="font-size: small;">Assist in the planning and implementation of clinical programs to prevent and control diseases and to improve quality and efficiency of care delivered to BCBSM insured population.&nbsp; </span></li> <li><span style="font-size: small;">Design and implement epidemiologic studies to evaluate the effectiveness of clinical programs.&nbsp; </span></li> <li><span style="font-size: small;">Prepare presentations and technical reports in a clear and concise manner to communicate finding from epidemiologic studies to management, providers and other interested parties.&nbsp; </span></li> <li><span style="font-size: small;">Disseminate research results through presentations to scientific and professional groups and through publications in scientific and professional journals.&nbsp; </span></li> <li><span style="font-size: small;">Provides consultation to Michigan providers, physician organization and other interested groups.&nbsp; </span></li> <li><span style="font-size: small;">Other duties may be assigned.&nbsp;</span></li> </ul> <div>&nbsp;</div>
Requirements: <div id="requisitionDescriptionInterface.ID1582.row1" class="inlinepanel" title=""><span class="subtitle">Qualifications</span></div> <ul> <li><span style="font-size: small;">Master's Degree in Public Health, Epidemiology, Health Administration or other related field</span></li> <li><span style="font-size: small;">At least two (2) years experience in Epidemiology or related field</span></li> <li><span style="font-size: small;">Knowledge of complex epidemiologic and surveillance methods</span></li> <li><span style="font-size: small;">Knowledge of current concepts of population health manage, program evaluation and needs assessment</span></li> <li><span style="font-size: small;">Knowledge of health insurance and health care industry in general, more specific about BCBSM business, products and programs.</span></li> <li><span style="font-size: small;">Must possess a working knowledge and understanding of how physicians and other providers practice can vary.</span></li> <li><span style="font-size: small;">Ability to write reports for internal and external customers.</span></li> <li><span style="font-size: small;">Ability to function independently, manage multiple tasks and work effectively under minimal supervision.</span></li> <li><span style="font-size: small;">Working knowledge of PC and mainframe applications and computer systems.</span></li> <li><span style="font-size: small;">Ability to present and defend work findings and decisions under the stress of conflict and challenges while maintaining a professional image.</span></li> <li><span style="font-size: small;">Strong analytical, organizational, verbal and written communication skills.</span></li> <li><span style="font-size: small;">Strong working knowledge of data languages such as SAS or SQL.</span></li> </ul> <div><strong><span style="font-size: small;">Department preferred EDUCATION AND/OR EXPERIENCE:</span></strong></div> <ol> <li> <div><span style="font-size: small;">Master's Degree in Public Health, Epidemiology, Health Services Research, Health Administration, Nursing/Clinical discipline, Health Policy, or other related field; quantitative training is required.&nbsp;</span></div> </li> <li> <div><span style="font-size: small;">At least two (2) years of experience in applied health services research.&nbsp;</span></div> </li> <li> <div><span style="font-size: small;">At least two (2) years of experience in a payer or related environment.&nbsp; Experience with &nbsp;health insurance products, such as PPO, HMO, or commercial Medicare.&nbsp; Experience in fee-for-value programs.&nbsp; Exposure to payer issues such as network management, cost of care, hospital readmissions, and in-patient admissions.</span></div> </li> <li> <div><span style="font-size: small;">Quantitative experience in population health management, quasi-experimental design, survey design and analysis, observational data methods, sampling techniques, metric development, risk adjustment, attribution methodologies, and needs assessment.&nbsp; Experience in a clinical area a plus.</span></div> </li> <li> <div><span style="font-size: small;">Experience in CMS guidelines, ICD-10, HCPCS and CPT codes.&nbsp; Experience in HL7 a plus.</span></div> </li> <li> <div><span style="font-size: small;">Knowledgeable in SAS and SQL programming languages. Familiarity in mining databases&nbsp; Programming experience in R, SPSS, Python or other statistical analysis packages a plus.</span></div> </li> <li> <div><span style="font-size: small;">Excellent oral, listening, and written communication skills that includes presentation of analytic results to a public speaking audience. Prior consulting experience a plus.</span></div> </li> <li> <div><span style="font-size: small;">Familiarity with analyzing electronic medical records, unstructured data, and/or registry data a plus.</span></div> </li> </ol>