Lead Clinical & Population Health Analyst - HEDIS
Company: Highmark Health
Location: Trenton
Posted on: January 27, 2023
Job Description:
**Company :**
Highmark Health
**Job Description :**
**JOB SUMMARY**
This job creates data-driven insights which identify actionable
opportunities and/or create analytics and reporting solutions
aligned to the Quadruple Aim of Healthcare: lower per capita health
care costs, improved outcomes from and quality of care received,
and optimal member/patient and provider experiences with care
delivery. The incumbent serves as a consultative subject matter and
technical expert for internal and external customers, leveraging
advanced analytical expertise and experience to aggregate, analyze
and understand patterns in varied and complex data; and articulates
analytic findings, business implications, and recommendations to
realize identified opportunities.
**ESSENTIAL RESPONSIBILITIES**
- Leads the design, development, execution, dissemination and
interpretation of clinical and population health analyses, metrics
and reports using clinical, member, financial and administrative
data to identify, develop and/or monitor actionable opportunities
for improving health and healthcare outcomes and clinical quality
and costs of care, efficiently and effectively managing projects to
successful completion.
- Establishes strong, collaborative and effective relationships
and communication with internal and external clinical,
administrative, operational, financial and technical stakeholders
to ensure analytics are actionable and aligned with organizational
strategic priorities, needs, plans and resources.
- Serves as a strategic business partner to internal and external
stakeholders as demonstrated by providing thought leadership and
subject matter expertise, and by anticipating and actively
proposing, designing and executing analyses.
- Provides consultative, technical, subject matter and business
expertise mentorship to colleagues across the enterprise.
- Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Master's Degree in Public Health, Nursing, Economics, Health
Sciences, Informatics, Biostatistics, Statistics, Epidemiology or
Pharmacy or related field
**Substitutions**
+ Bachelor's Degree in Public Health, Nursing, Economics, Health
Sciences, Informatics, Biostatistics, Statistics, Epidemiology,
Pharmacy **OR** related field with 2 years of relevant work
experience in lieu of a Master's Degree OR 8 years of relevant work
experience
**Preferred**
+ Doctorate in Medicine, Public Health, Nursing, Economics, Health
Sciences, Informatics, Biostatistics, Statistics, Epidemiology,
Pharmacy or related field
**EXPERIENCE**
**Required**
- 7 years of leading the design, execution and dissemination of
clinical and population health reporting, analyses and studies of
progressive scope and complexity
- 7 years with coding languages, analytical software, systems,
tools and processes using claims, clinical, enrollment and provider
data
- 5 years of project leadership in a complex, matrixed
environment (payer and/or provider preferred)
- 5 years of providing analytical consultation to clinical,
administrative, operational and financial stakeholders
**Preferred**
+ None
- *LICENSES or CERTIFICATIONS**
- *Required**
+ None
**Preferred**
+ None
**SKILLS**
- Demonstrated record of data-driven discovery, intense
intellectual curiosity, and a passion for working with data to
answer important questions about clinical care and population
health that drive the Quadruple Aim
- Strong working knowledge of coding languages, relational
databases, quantitative and qualitative analytic methodologies,
advanced analytics and statistics
- Excellent communication and facilitation skills with project
team members, stakeholders, executives, and external customer,
exceptional written and oral presentation skills, proven ability to
communicate interpersonallly and technically with technical and
non-technical, and internal and externbal audiences, and the
ability to lead through influence
- Healthcare industry expertise and experience, knowledge about
the shifting healthcare environment including trends concerning
health insurance, healthcare delivery, provider relationships and
regulatory issues
- Sophisticated knowledge of how organizations work and how to
get things done through formal and informal channels
- Exhibition of perseverance through energy, drive and
demonstrated success when resistance or setbacks are
encountered
- In-depth understanding of and experience with both clinical and
business processes, and the ability to identify opportunities for
improvement and develop solutions
- Demonstrated ability to informally lead matrixed teams of
technical, clinical, administrative, financial and operational
staff to achieve shared organizational objectives and strategic
goals
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
- *PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
- *Position Type**
Office-based
Teaches / trains others regularly
Frequently
Travel regularly from the office to various work sites or from
site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales
employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
- *_Disclaimer:_** _The job description has been designed to
indicate the general nature and essential duties and
responsibilities of work performed by employees within this job
title. It may not contain a comprehensive inventory of all duties,
responsibilities, and qualifications required of employees to do
this job._
- *_Compliance Requirement_** _: This job adheres to the ethical
and legal standards and behavioral expectations as set forth in the
code of business conduct and company policies._
- As a component of job responsibilities, employees may have
access to covered information, cardholder data, or other
confidential customer information that must be protected at all
times. In connection with this, all employees must comply with both
the Health Insurance Portability Accountability Act of 1996 (HIPAA)
as described in the Notice of Privacy Practices and Privacy
Policies and Procedures as well as all data security guidelines
established within the Company's Handbook of Privacy Policies and
Practices and Information Security Policy._
- Furthermore, it is every employee's responsibility to comply
with the company's Code of Business Conduct. This includes but is
not limited to adherence to applicable federal and state laws,
rules, and regulations as well as company policies and training
requirements._
- ments._
Highmark Health and its affiliates prohibit discrimination against
qualified individuals based on their status as protected veterans
or individuals with disabilities, and prohibit discrimination
against all individuals based on their race, color, age, religion,
sex, national origin, sexual orientation/gender identity or any
other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to
employ and advance in employment individuals without regard to
race, color, age, religion, sex, national origin, sexual
orientation/gender identity, protected veteran status or
disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected
Veterans/Disabled/Sexual Orientation/Gender Identity ( _ )
We endeavor to make this site accessible to any and all users. If
you would like to contact us regarding the accessibility of our
website or need assistance completing the application process,
please contact number below.
For accommodation requests, please contact HR Services Online at
HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and
Applicants Notice
Req ID: J221408
Keywords: Highmark Health, Trenton , Lead Clinical & Population Health Analyst - HEDIS, Professions , Trenton, New Jersey
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