Lead Health Informatics Analyst

United States

Job Description

Lead Health Informatics Analysts will be expected to produce analytics that drive Magellan’s comprehensive clinical strategy and operational effectiveness. This role works directly with senior and junior leadership across business units to develop meaningful research, conduct data analyses, develop clinical algorithms, and present technical information to audiences across the organization. Candidates will be expected to demonstrate leadership and constructive, persuasive advisement on product development and evaluation strategies and advocate for accuracy and efficiency.

This position will have key responsibilities over Risk Adjustment activities, primarily (though not limited to) Medicaid.
  • Perform analyses using large data sets to evaluate objectives including patient healthcare outcomes, intervention program effectiveness and/or profitability/ROI.
  • Manipulate large data sets and navigate a variety of data types and data structures to complete analyses, including the ability to summarize, quality check, and evaluate data.
  • Coordinate and respond to a variety of analytic requests and demonstrate the ability to change direction and adhere to the short timelines of a rapidly changing environment.
  • Partner across the organization to document and communicate results of analyses as well as the processes used to develop the research methodology; significantly contribute to the development of standard methodologies and analytical techniques. Facilitate activities of other staff engaged in analytical efforts.
  • Define the scope of projects, consult with clients to determine research needs, construct and negotiate project timetable with client, evaluate data and deliverable relative to client’s expectations, and manage projects from concept to final deliverable.
  • Maintain familiarity with current trends in healthcare research and policy.
  • Perform analyses using large data sets to evaluate objectives including patient healthcare outcomes, intervention program effectiveness and/or profitability/ROI.
  • Manipulate large data sets and navigate a variety of data types and data structures to complete analyses, including the ability to summarize, quality check, and evaluate data.
  • Coordinate and respond to a variety of analytic requests and demonstrate the ability to change direction and adhere to the short timelines of a rapidly changing environment.  Requires high-level direction with very limited supervision.
  • Partner across the organization to document and communicate results of analyses as well as the processes used to develop the research methodology; significantly contribute to the development of standard methodologies and analytical techniques. Facilitate activities of other staff engaged in analytical efforts.
  • Define the scope of projects, consult with clients to determine research needs, construct and negotiate project timetable with client, evaluate data and deliverable relative to client’s expectations, and manage projects from concept to final deliverable. 
  • Maintain familiarity with current trends in healthcare research and policy.
  • Provides status reports that give a detailed description of the current project's progress and indicates time devoted to each task of the project.
  • Tracks and assigns ownership of project level issues. Escalates issues to the proper level of management.
  • Coordinates/mentors analytic efforts performed by in- house staff or outside consultants to ensure that all work is completed according to the project plan.
  • Interpret results and preparation of data findings in easily understandable format for varying levels of the organization.
  • Track and report key Risk Adjustment metrics over time, segmented to highlight areas of exposure and opportunity.
  • Lead and develop a combination of in-house and vendor analytic strategies to optimize diagnosis capture, and regularly report on progress and captured revenue.
  • Maintain data governance and monitor for complete and accurate data.  Employ automation where possible.
  • Develop operational efficiencies by collaborating with internal and external partners and leveraging Risk Adjustment data in innovative ways (e.g. combining coding gaps with HEDIS gaps).
  • Understand and communicate the impact of state/CMS Risk Adjustment methodology and rate changes.
  • Generate Risk Adjustment targets/goals and forecast revenue in future periods, in light of methodological/rate changes as well as internal trends and anticipated growth.

General Job Information

Title

Lead Health Informatics Analyst

Grade

27

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

3/4/2019

Date Requisition Created

2/18/2019

Minimum Qualifications

Education

Bachelors: Computer and Information Science (Required), Bachelors: Mathematics (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Experience working with normalized and denormalized data structures; experience with SAS, SPSS and/or other data mining tools. Demonstrated competency in developing efficient and effective solutions to complex business problems. Experience with healthcare medical and pharmacy claims data manipulation and analysisMasters degree in technical or analytic field (e.g. computer science, statistics); Understanding of CPT and ICD-9 codes preferred; strong oral and written communication skills; and interest in healthcare and a passion to make a difference; effective listening and communication skills; ability to work under tight deadlines in a dynamic environment. Ability to work under tight deadlines in a highly dynamic environment. Strong analytic and problem-solving skills and ability to interpret results of query analyses. Ability to develop and communicate analytic results to support business questions; must be capable of translating complex IT and computer concepts to unfamiliar users of the information at the executive level.5+ years of transact-SQL (MS SQL or Oracle) experience

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”