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About the Role

Responsible for the design and buildout of trend prediction capabilities across key clinical and affordability metrics, this individual will build expert-level clinical metrics into the broader CHC Risk Ecosystem. Candidates should be very familiar with the intersection of clinical data with predictive techniques including authorization data, service category, and diagnosis drivers. Key stakeholder groups include clinical and affordability teams, analytics, and finance.

Responsibilities

Buildout key clinical risk indicators and projection insights into the CHC Risk Ecosystem
Partner with clinical & financial stakeholders to design and implement effective clinical analysis capabilities and key performance indicators into trend analysis & claim insights
Unpack relationships between key clinical drivers, including authorizations, claims, diagnostic categories, and episodes of care in the CHC Risk Ecosystem
Own end-to-end development of innovative clinical insights and affordability opportunities, seeking continuous improvement
Influence the cost of care through enhancement of predictive capabilities to deliver data-driven insights
Utilize external data to drive deeper connections between internal clinical data and marketplace trends
Leverage large datasets in analysis, partnering with technical and visualization teams as applicable
Serve as a strategic business partner with multiple cross-functional areas including clinical, financial, and technical stakeholders to improve operational efficiency, accuracy, and depth of data-driven clinical insights

Requirements

5+ years' of experience in medical economics/health-plan data analytics, affordability or clinical analysis
Advanced experience with SQL, Python and/or other similar data tools
Familiar with key clinical coding (CPT/ICD10) concepts and data
Proven core clinical knowledge including provider data, clinical information, claims data and health plan performance including cost and quality objectives
Experience in working successfully in a matrix environment with demonstrated ability to collaborate
Effective storytelling skills and business acumen are key competencies
If working from home occasionally or permanently, internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Skills

SQL
Python
Data Analysis
Clinical Coding (CPT/ICD10)
Clinical Knowledge
Storytelling
Business Acumen

Experience Level

Senior Contributor
5+ years

Salary/Compensations

98,200 - 163,600 USD / yearly

Benefits

Medical
Vision
Dental
Well-being and behavioral health programs
401(k)
Company paid life insurance
Tuition reimbursement
18 days of paid time off per year
Paid holidays
Annual bonus plan

About the Company

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions.
Our people make all the difference in our success.

Equal Opportunity

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.