Job Description

Join the Health Care Value Strategic Informatics and Program Performance team where you will be responsible for leveraging advanced analytics, predictive modeling, and data visualization to generate actionable insights that improve healthcare outcomes, optimize program performance, and support strategic decision-making. This role partners with business leaders, clinical teams, pharmacy services, and operational stakeholders to analyze healthcare data, identify trends, evaluate program effectiveness, and provide data-driven recommendations related to cost, quality, utilization, and member outcomes.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

1. Analyze large volume of health care claims data using advanced statistics/machine learning methods to understand existing and predict future health care trends and anomalies.
2. Proactively discovers potential areas for medical cost improvement and management/healthcare initiative strategies.
3. Provide statistical support and consultation to program owners and leadership
4. Prepare presentations and technical reports in a clear and concise manner to communicate findings to business owners, vendors, Michigan providers and other interested parties.
5. Strong verbal and written communication skills.
6. Ability to function independently, manage multiple tasks and work effectively under minimal supervision.

Departmental Summary / Preferences:

1. At least two years' proven ability to develop and implement advanced statistical/machine learning methods used in analyzing health care data and in data mining.
2. Advanced SQL knowledge and at least 2 years' of hands-on experience with Python/Pyspark
3. Experience with data visualization platforms such as Power BI or Tableau.
4. Experience working with healthcare claims, pharmacy, clinical, or population health data.
5. Experience with developing standardized, reusable analytic processes and reporting frameworks to improve accuracy, consistency and reproducibility across projects.

QUALIFICATIONS

• Master's Degree in Statistics, Biostatistics or Health Economics.
• At least two (2) years of experience in statistics, biostatistics, or health economics.
• Proven ability to develop and implement advanced statistical methods used in analyzing health care data and in data mining.
• Extensive knowledge of health insurance and health care industry in general and specifics about BCBSM business, products, and programs.
• Must possess a working knowledge and understanding of methods and challenges in provider performances evaluation.
• Ability to write reports for internal and external customers.
• Statistical experience in development and execution for appropriate methodology with the ability to explain statistic findings to non-statistician individuals.
• Ability to function independently, manage multiple tasks and work effectively under minimal supervision.
• Ability to present and defend work findings and decisions under the stress of conflict and challenges while maintaining a professional image.
• Strong analytical, organizational, verbal, and written communication skills.
• Strong working knowledge of data languages such as SAS, R, Python, SQL, or equivalent.

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