Health Information Data Scientist
Blue Cross Blue Shield Kansas

Job Info

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Under the general direction of the Manager of Health Analytics, the Health Information Data Scientist carries primary responsibility for activities related to identifying, extracting, organizing, storing, analyzing, reporting, researching, and modelling data in support of corporate, divisional, and departmental health analytic initiatives. Position is responsible for designing, maintaining, and overseeing effective approaches for finding valuable insights from large, rich datasets that will produce more effective, efficient, and automated data reporting solutions; reduce the total cost of care by eliminating fraud, waste, and abuse; identify billing, coding and utilization patterns, trends, and outliers; research member, employer, clinical, and provider data to generate standard and ad hoc reports; and ultimately use analytics to transform data into actionable insights and recommendations in order to meet corporate goals and changing market demands.

"This position is eligible to work onsite or hybrid (9 or more days a month on site) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Why Join Us?

• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
  
• Family Comes First: Total rewards package that promotes the idea of family first for all employees.
  
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
  
• Stability: 80 years of commitment, compassion and community
  
• Flexibility: options to work onsite or hybrid available
  
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
  
• Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected.
  
  

Compensation

$105,920 - $126,000 annually
IT&S 17

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.
  

What you'll do

• Develop, implement, and maintain data systems and processes to support divisional medical management, provider quality, reporting, and data retrieval needs.
  
• Analyze healthcare data using statistical and data mining techniques to identify patterns, develop models, and provide strategic insights for corporate and Medical Affairs initiatives.
  
• Work with business users at all levels to understand their requirements and translate them into analytical models and automated processes.
  
• Present data-driven insights in clear, visually appealing formats for internal stakeholders and senior management.
  
• Support the resolution of complaints and issues related to overutilization, underutilization, billing practices, and provider patterns through data analysis and reporting.
  
• Propose and implement new analytics solutions to address business needs and optimize data processes.
  
• Collaborate with subject matter experts, data stewards, IT, and business analysts to prepare internal and external data for analysis.
  
• Participate in corporate projects and committees affecting data systems, health analytics, and utilization reporting.
  
• Contribute to the development of policies and procedures related to medical, reimbursement, and administrative matters, including new procedures and cost containment programs.
  
• Monitor new healthcare trends, technologies, and data sources to assess impacts on medical management and delivery systems (e.g., value-based programs, provider quality, interoperability).
  
• Maintain expertise in vendor analytics software and work with IT resources to optimize data processing, input, and output.
  
• Lead the corporate Ad Hoc Client Committee and coordinate changes to the corporate Data Warehouse and delivery of data to clients (e.g., Kansas Health Insurance Information System).
  
• Serve as a technical resource for divisional staff on data systems, health analytics, and provider/insured contracts, policies, and procedures.
  
• Provide training on data system capabilities and post-payment health analytics methodologies.
  
• Ensure achievement of objectives for the Health Analytics department, Medical Affairs division, and organizational goals.
  
• Initiate and coordinate system improvements to increase data efficiency and effectiveness.
  
• Support the development and implementation of systems and standards for health analytics and data reporting.
  

What you need
Knowledge/Skills/Abilities
• Ability to identify and make sense of rich data sources, manage large amounts of data, merge datasets, ensure consistency of datasets, graphically portray data to gain insights, build statistical models, understand data and model shortcomings, and effectively communicate findings.

• Must possess advanced analytical, problem solving, and research skills.

• Adept at programming with SQL and capable of learning computer programming languages.

• Ability to understand the capabilities, limitations, and characteristics of the corporate data systems and build relationships with subject matter experts throughout the company.

• Ability to work with statistical software applications, such as R, SAS, Python, or Minitab.

• Ability to work with data visualization tools, such as Tableau.

• Skilled with Microsoft Excel, Access, and Word.

• Ability to understand and build solutions that recognize a variety of distinct data reporting requirements.

• Ability to create and maintain databases and produce actionable insight and visualization capabilities from those data sources for management reporting and process improvement.

• Must effectively use interpersonal and communications skills with tact and diplomacy. This position maintains interaction with internal and external customers of all levels of staff.

• Must have excellent written and oral communication skills, with the ability to convince and defend the reasonability of research findings and process designs to a wide array of both technical and non-technical persons.

Must maintain and grow knowledge, skills, and abilities in data analytics and technologies to support the data needs of the department, division, and corporation.

• Ability to make decisions using independent judgment and creativity to resolve issues and overcome roadblocks.

• Must be proficient at advancing multiple projects simultaneously and prioritizing activities based on immediate business needs.

• Ability to collaborate with team members, sharing knowledge and embracing feedback.

• Ability to think creatively and look for new ideas for improving performance, processes, and operational efficiency.

• Ability to perform quality control checks and audits for data integrity.

• Excellent attention for detail

• Must have strong project management skills.

Education and Experience
• Bachelor's degree in technology, mathematics, statistics, actuarial science, risk management, economics, or related field is required. Master's degree preferred.

• At least three (3) years in technology, statistics, actuarial science, applied mathematics, financial economics, data structures and system applications or system mainframe applications in a DB2 environment is required.

• Experience with and understanding of data warehouse structures, data extraction tools, analytics software and methods, and data modeling is required.

• Experience with and knowledge of the healthcare delivery system and the health insurance industry is preferred.

• Understanding of health insurance and clinical data content and structure is highly preferred.

Benefits & Perks

• Base pay is only one component of your competitive Total Rewards package
  
• Incentive pay program (EPIP)
  
• Health/Vision/Dental insurance
  
• 6 weeks paid parental leave for new mothers and fathers
  
• Fertility/Adoption assistance
  
• 2 weeks paid caregiver leave
  
• 5% 401(k) plan matching
  
• Tuition reimbursement
  
• Health & fitness benefits, discounts and resources
  

Our Commitment to Diversity, Equity, Inclusion, and Belonging

At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.

We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.

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