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Decision Support Analyst

Design and implement advanced data models to support Medicaid health outcome improvements
Pittsburgh, Pennsylvania, United States
Senior
14 hours agoBe an early applicant
Pennsylvania Staffing

Pennsylvania Staffing

Pennsylvania Staffing is not a known company associated with the domain pennsylvania.gov, which is typically used for official state government services.

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Medicaid Population Health Analytics Role

Company: Highmark Inc. Job Description: JOB SUMMARY This role on the Medicaid Population Health Analytics team works closely with cross-functional areas, including Clinical, Quality, Medical Management, and Technology, to prioritize data and information requirements. The incumbent is responsible for conducting investigative clinical analysis, risk stratification, and health outcome evaluations specifically for Medicaid populations across a multi-state program. The primary intent is to identify opportunities to improve health outcomes and achieve financial value from implemented clinical programs. This position determines how decision support systems will provide information required for effective business decisions, translating complex requirements into applications that employ appropriate decision support and reporting tools. The incumbent recommends innovative analytical approaches and translates findings through data to clinical stakeholders, contributing to a data-driven approach for enhancing population health strategies.

Essential Responsibilities

  • Develop and foster internal relationships across the corporation.
  • Provide analytic and consultative support to a broad spectrum of internal customer areas and external business partners.
  • Mentor colleagues with less experience on both the technical and business aspects of project and consultative work.
  • Determine how decision support systems will provide information required to make effective business decisions, translates requirements into applications that employ appropriate decision support and reporting tools.
  • Use broad experience and technical knowledge to propose solutions to complex business problems.
  • Take the lead in driving the implementation of the recommended solutions.
  • Take the lead in defining issues and ideas to be studied as well as the approach (methodological and technical) to be used in addressing studies and projects. Creates and/or develop new methods of analysis, database design and performance measurement or, in some cases, adaptation of existing solutions to new areas.
  • Perform modeling of data sources and flows, work with data management staff to define an operational framework that will define, develop and implement policies and security frameworks to ensure precise and secure deliver of knowledge and information.
  • Provide assistance and, depending on skill and experience, lead with interpretation of raw data, statistical results or otherwise compiled information, identify follow-up action items and prepare or assist in the preparation of written reports and/or oral presentation of findings to internal and external audiences, customer managers, clinical staff, compliance agencies, group accounts, providers, agent plans, and brokers.
  • Develop and maintain moderate- to extremely-complex computer programs using 4GL programming languages (such as SAS, R, SQL) and other database technology (DB2, Teradata, and Oracle).
  • Other duties as assigned or requested.

Education

Required: Bachelor's Degree in Computer/Information Science, Mathematics/Statistics, Economics, or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree Preferred: Master's degree in Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research, or related field

Experience

Required: 3 years of relevant, progressive experience in Industrial Engineering or Operations Research, or related field (exempted experience requirements effective August 2016) Preferred: Experience and demonstrated proficiency as a Decision Support Analyst or equivalent training and experience in a business or clinical environment with direct responsibility for applying technology

Skills

Strong technical skills in the mainframe, PC and Internet-based technologies to be effective and must be comfortable and proficient using large and complex databases. Strong skills using various third-party office and report generation products such as Microsoft Office, Business Objects, Cognos, and Enterprise Guide. Strong communication skills. Must be comfortable presenting findings and offering recommendations to senior management.

Physical, Mental Demands and Working Conditions

Position Type: Office-based Teaches / trains others regularly Never Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271607

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Decision Support Analyst
Pittsburgh, Pennsylvania, United States
Support
About Pennsylvania Staffing
Pennsylvania Staffing is not a known company associated with the domain pennsylvania.gov, which is typically used for official state government services.