Director, HCV Data Analytics, Program Evaluation & Reporting

<p>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.</p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" 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="http://www.bcbsm.com/index/about-us/our-company.html" 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="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.&nbsp; http://www.bcbsm.com

keywords: strategy,leadership,reporting,critical thinking,solutions,analysis,economic,research,experience,knowledge,organization,degree,communication,research,professional

Masters, PhD is preferred

Competitive Total Compensation Package

Overview: <p>Description</p> <p>&nbsp;</p> <p>Oversee and develop strategy for Clinical Epidemiology and Biostatistics (CEB) and Medical Informatics (MI), which are responsible for the analytic and reporting needs of clinical programs and initiatives, including hospital and physician pay-for-performance incentive programs, patient-centered medical home (PCMH) initiatives, specialist fee uplift analytics for 40+ specialty types, health plan quality accreditation for National Committee for Quality Assurance (NCQA), Health Plan Employer Data and Information Set (HEDIS), pharmacy-related analytics and wellness and care management, clinical aspects of network analysis for new products and customer reporting.</p>
Responsibilities: <p>Direct health care, epidemiological, economic design in Health Care Value (HCV) programs and lead development of analyses to understand financial and membership impact. Lead teams focused on conducting advanced analytics such as opportunity analyses, risk adjustment and predictive modeling, program evaluation studies, customer reporting, product development, and ad-hoc analytics to inform business strategies and payment policy recommendations.&nbsp;</p> <p>Lead CEB and MI teams for data analytics of clinical programs and provider performance reporting. Develop employer reporting for various HCV customers such as PCMH, Wellness and Care Management (WCM), Physician Group Incentive Program (PGIP), Sales, Actuary and Finance. Conceptualize data solutions and report scientific findings through study designs, training, data integrity, validity and program development. Understand risks for program development, analyze and report research to make informed decisions.</p> <p>Mentor and coach direct and indirect reports.&nbsp; Lead CEB &amp; MI to partner with IT to enable building of data solutions usable for business analytics and to execute the business needs.</p> <p>Provide critical thinking and training for advanced analytics, study design, and validity to measure provider performance.</p> <p>Direct development of reporting and analyses for health plan for Quality Management and NCQA Accreditation.</p> <p>Direct development of department scientists to publish research to create educational and scientific awareness of BCBSM&rsquo;s Epidemiology, Biostatics, Healthcare Economics, and Medical Informatics initiatives.</p>
Requirements: <p>Qualifications</p> <p>&nbsp;</p> <p>Masters in related field such as Medical Informatics, Epidemiology, Quantitative Research, Public Health Administration, or Public Health Policy, or MD is required.&nbsp; PhD is preferred.</p> <p>Extensive knowledge of Epidemiology and Data Analytics</p> <p>Eight (8) years&rsquo; experience managing professionals in the field of Epidemiology, Biostatistics, Healthcare Economics, Psychology, or Public Health Administration/Policy.</p> <p>Five (5) years&rsquo; experience leading an advanced analytic team.</p> <p>Five (5) years&rsquo; experience with claims data (preferably in payor setting).</p> <p>Experience with peer-reviewed publishing scientific research and articles preferred.</p> <p>Ability to work with Executives and academicians to advance research of member healthcare costs and provider rewards related to value-based care.</p> <p>Advanced mathematical and analytic skills such as theory, advanced statistical methods, business process metrics, outcome measurement, process modeling and quality assessment.</p> <p>Excellent written and verbal skills to communicate complex ideas.</p> <p>Strong working knowledge of programming languages such as SAS and SQL.</p> <p>Ability to work independently, within a team environment and communicate effectively with employees at all levels.</p> <p>Solid working knowledge of reporting tools and software (i.e. Excel, Visio, Access, Power Point, statistical software).</p> <p>All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.</p> <p>&nbsp;</p> <p>Job Health Care Management</p> <p>Primary Location Detroit</p> <p>Organization HCV Performance &amp; Execution-2140</p> <p>Schedule Full-time</p>