Medical Informatics Analyst Sr at Blue Cross Blue Shield of Michigan in Detroit, Michigan

Job Description:

Provides technical, data and software support to customer departments such as Clinical Epidemiology and Biostatistics, Value Partnerships, Hospital Contracting, Wellness Care Management and HCV Center of Excellence.

• Leads projects with minimum direction where data solutions are necessary. Provides programming and data expertise for complex projects and ad-hoc requests. 


• Presents data and solutions to internal and/or external customers in a logical way. Provides data support and analysis for programs supporting over 4 million BCBSM beneficiaries using administrative claims data totaling $20 billion per year. 


• Provides analysis and data support for various corporate departments including Value Partnership, Wellness Care Management, Hospital Contracting, and Center of Excellence in support of major corporate initiatives such as PGIP, RMRA, STARS and NCQA/HEDIS. 


• Standardizes, harmonizes, cleans and shares data with others in the organization as well as external customers. 


• Creates and maintains data-centric product solutions, including third party program integrations such as CAVE, HEDIS, risk scores and the Oliver Wyman PGIP Savings Model. 


• Supports various reporting activities and continuously strives to make them more efficient and easier for the customers to consume. 


• Completes ad-hoc data and analytic requests as assigned. 


• Works with HCV-IT and Clinical Epidemiology and Biostatistics to maintain and enhance our Clinical Program Data Mart. 


• Provides mentoring and oversight to co-workers. 


• Leads projects and other analysts may provide support.  


• Other duties as assigned.

" Qualifications"

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  Bachelors Degree in Computer Science, Information Systems, Business, Mathematics, Healthcare Information Technology or similar degree required.
  


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  Master's Degree preferred.
  


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  Minimum 6 years of progressively more responsible related work experience.
  


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  Ability to use advanced functions in SQL or SAS or SPSS programming.
  


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  Solid working knowledge of Microsoft tools and software (i.e., Excel, Visio, Access, PowerPoint).
  


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  Competency in programming concepts such as Visual Basic, Business Objects, .Net, MDX, C++, or COBOL.
  


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  Must possess the ability to help others think critically and share complex technical solutions to non-technical audiences both orally and in writing.
  


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  Must be able to translate thoughts and ideas from non-data customers into data-centric solutions.
  


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  Knowledge of data warehousing and data mining concepts including but not limited to ETL, datamart design, fact tables, dimension tables, data views within data marts/data warehouses, olap, rolap and data models such as star schemas and snowflake schemas.
  


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  Ability to recognize data patterns, quantify potential issues and identify solutions.
  


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  Ability to standardize, harmonize, clean, prepare and use data for developing datasets, reporting and analysis.
  


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  Basic understanding of epidemiologic principals and population health management concepts desirable.
  


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  Knowledge of healthcare terminology, plan/benefit design and fundamental operational principles and administrative claims data including standard coding schemes such as ICD-9/10 and HCPCS.
  


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  Must possess strong leadership skills.
  

Department Summary / Preferences:

Responsible for design and development of data architecture and ETL data flows in support of enterprise HEDIS data management, analytics, and reporting.

Develop comprehensive project plans that merge business requirements with goals and coordinate with various managers and technical personnel during all project phases, from initial development through implementation.

Ensure adherence to the Project Management methodology and quality standards, oversee various high-priority projects of mid to large size.

Experience with HEDIS Data Management & HEDIS Engine execution.

Possess demonstrated knowledge of healthcare and /or managed care principles and relational databases(Oracle, SQL Server).

Knowledge of HEDIS, STARS, and NCQA Accreditation. Master’s degree preferred.

Bachelor’s degree required in a related field such as Computer Science, Information Systems, Business, Healthcare Information Technology or similar degree required.

Project Management experience is preferred.

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.