Medical Informatics Analyst, Consultant- Medical Programs

About the role

The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our customers and contain the rising cost of healthcare. The Medical Informatics, Consultant will report to the Manager of HQA Analytics.

Responsibilities

• Conduct independent analysis of high complexity under minimal supervision and guidance
• Develop analytical methods so that they may be subsequently delegated for production to Medical Informatics Analysts at lower levels
• Produce analysis of high complexity under the guidance and direction of Medical Informatics Analyst V, supervisor or manager
• Create and execute workplans for analyses of high complexity. Workplans may coordinate the activities of Medical Informatics Analysts at lower levels and may involve collaboration with more than one team
• Build and maintain robust data models for cost of savings data, sometimes integrating multiple data sources (e.g., authorization, medical care programs, case management, and claims data) and ensuring alignment with business rules, data quality standards, and reporting requirements
• Develop methodologies and data models to calculate baseline vs. realized savings of clinical programs, including avoided costs and trend adjustments
• Responsible for providing key performance indicators on clinical programs, particularly surrounding program usage

Qualifications

• Requires a college degree or equivalent experience
• Requires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent
• Requires at least 7 years of prior relevant experience
• Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Requires proficiency in one or more dashboard/BI tools, such as Power BI or Tableau
• Requires at least 3 years of data modeling experience, and advanced proficiency in SQL for complex query development, data transformation, and performance optimization across large-scale datasets
• Demonstrated financial acumen with a deep understanding of healthcare cost structures, including but not limited to drivers of medical expense such as utilization, unit cost, site of care, and member risk profile
• Experience evaluating and calculating return on investment for clinical program participation, including measuring program costs against realized savings and outcomes to assess financial effectiveness and value

Benefits

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Pay

Pay Range for California: $123,090.00 to $184,800.00
Pay Range for Bay Area: $138,756.00 to $208,320.00

Schedule

Full time
Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.