<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. http://www.bcbsm.com

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Competitive Total Compensation Package

Overview: <p>Independently leads health research projects by performing conceptualization, design, execution, and interpretation of novel BCBSM fee-for-value and risk-based initiatives.&nbsp;</p> <p>Partners with HCV, HPB, and EM staff to provide well-defined, accurate, and timely analyses that answer client questions; drives the completion of these analyses through project management of other HCVDA staff.</p> <p>Monitors existing programs, and leverages evidence based analyses to guide decision making across various health insurance products. &nbsp;Provides leadership that yield quantitative collaborations to enhance health care value.</p>
Responsibilities: <p><strong>Essential Duties and Responsibilities include the following</strong>;</p> <ul> <li>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 CEB staff member. Executes implementation of research questions on defined data sources.</li> <li>Serves as lead for defined projects and executes project management with other HCVDA staff.&nbsp; Responsible for providing high quality, accurate, and timely project deliverables.</li> <li>Supports strategic discussions with CEB Leadership and leadership across HCV and BCBSM by providing model results derived from BCBSM data marts and registries.</li> <li>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.</li> <li>Interprets and presents results to a variety of quantitative and non-quantitative audiences.</li> <li>Defines programming specifications for analyses and validates the programming of other HCVDA staff.&nbsp; Performs primary programming for exploratory data analysis.</li> <li>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.</li> <li>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; </li> <li>Identify opportunities for clinical programs.&nbsp; </li> <li>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; </li> <li>Design and implement epidemiologic studies to evaluate the effectiveness of clinical programs.&nbsp; </li> <li>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; </li> <li>Disseminate research results through presentations to scientific and professional groups and through publications in scientific and professional journals.&nbsp; </li> <li>Provides consultation to Michigan providers, physician organization and other interested groups.&nbsp; </li> <li>Other duties may be assigned.</li> </ul>
Requirements: <ul> <li>Master's Degree in Public Health, Epidemiology, Health Administration or other related field</li> <li>At least two (2) years experience in Epidemiology or related field</li> <li>Knowledge of complex epidemiologic and surveillance methods</li> <li>Knowledge of current concepts of population health manage, program evaluation and needs assessment</li> <li>Knowledge of health insurance and health care industry in general, more specific about BCBSM business, products and programs.</li> <li>Must possess a working knowledge and understanding of how physicians and other providers practice can vary.</li> <li>Ability to write reports for internal and external customers.</li> <li>Ability to function independently, manage multiple tasks and work effectively under minimal supervision.</li> <li>Working knowledge of PC and mainframe applications and computer systems.</li> <li>Ability to present and defend work findings and decisions under the stress of conflict and challenges while maintaining a professional image.</li> <li>Strong analytical, organizational, verbal and written communication skills.</li> <li>Strong working knowledge of data languages such as SAS or SQL.</li> </ul> <strong>Department Preferred Education and/or Experience:</strong><br /> <ul> <li>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.</li> <li>At least two (2) years of experience in applied health services research.</li> <li>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.</li> <li>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.</li> <li>Experience in CMS guidelines, ICD-10, HCPCS and CPT codes.&nbsp; Experience in HL7 a plus.</li> <li>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.</li> <li>Excellent oral, listening, and written communication skills that includes presentation of analytic results to a public speaking audience. Prior consulting experience a plus.</li> <li>Familiarity with analyzing electronic medical records, unstructured data, and/or registry data a plus.</li> </ul>