Aug 20, 2019
Who we are: Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry. We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide. Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities. A Day in the Life of a Data Scientist: The Data Scientist is part of a team that researches and investigates business problems through quantitative analysis using healthcare cost, utilization, clinical, assessment, and external data. This position also conducts the on-going presentation of analysis results and findings to support clinical programs, healthcare business operations, performance and improvement.
Essential Functions: Gather and prepare analyses based on information from internal and external sources to evaluate and demonstrate program effectiveness and efficiency (10%) Leverage knowledge of programming, mathematics and computer science to transform the way our company does business Translate business opportunities into data-driven big-data and modeling solutions using statistical, econometric or data-mining tools and methods Analyze and extract data from the Enterprise Data Warehouse (EDW) to report to internal and external customers (5%) Working in big data environment with Oracle and Hadoop environment to bring actionable insights with R, SAS, Python or other statistical packages Research complex functional processes and industry standards using a variety of resources (5%) Educate the organization both from IT and the business perspectives on new analytic methods and technologies Develop and prepare highly complex reports and provide and/or interpret information and data across divisions and departments (15%) Communicate complex analysis clearly to all audience through use of data visualization tool such as Tableau Gain an understanding of how data integrates across multiple transaction systems to create complex reporting solutions for actionable insights Assume responsibility for data integrity among various internal groups and/or between internal and external sources (5%) Design integrated and clinically-based engineering, management, medical and environmental solutions aiming at providing person-centered care to members, households and their respective communities with emphasis on health, social, economic and environmental sustainability (15%) Using statistical methods such as linear models (linear regression, generalized linear regression, logistic regression) and nonlinear modeling techniques to build predictive models to help drive better member engagement and impactability Lead the research and development of predictive models and capabilities using machine learning and artificial intelligence Segment target population using supervised (classification) and unsupervised (clustering) learning methods to identify most impactful members Conduct economic/outcomes analyses to quantify savings obtained from integrated solutions.(10%) Evaluate return of investment (ROI), utilization and compare them with pre-defined goals to measure effectiveness of program Develop meaningful data visualizations in form of dashboards to communicate results and empower senior executives’ decision making process Develop systematic and scalable reporting processes and procedures to ensure timely delivery of weekly, monthly, quarterly, annual and ad hoc reporting to management (10%) Develop and improve algorithms like risk stratification methodology, pregnancy identification, etc. that is applied to all member on a monthly basis Recommend and implement new or modified reporting methods and procedures to improve report content and completeness of information (15%) Analyze benchmarking data, reports, processes, and measurements for key managed care indicators to recognize trends and assist in developing population health initiatives Serve as a mentor to junior staff (5%) Perform all other related duties as assigned (5%)
Job Requirements: Education: Master’s Degree or higher in Data Science, Biostatistics/Statistics, Econometrics or related field Experience: 5+ years of experience in advanced analytics experience, machine learning, statistics, or econometrics role and who has solid analytical skills using, SAS, R, or Python Advanced knowledge of statistical and mathematical principles Experience in Regression Analysis, Predictive Modeling, Data Mining, Machine Learning and Forecasting Experience in Propensity Modeling for control group and treatment group testing Experience in designing research experiments and measuring their effectiveness. Experience with healthcare claims data Experience with peer-reviewed publications Experience with Six Sigma, Triple Aim and/or other relevant Project Management tools Strong SQL Scripting, Statistical Programming, Data Visualization and Communication skills Ability to interpret and communicate statistical results to a non-technical audience Working knowledge of Predictive Modeling and Grouper tools such as John Hopkins ACG System , Optum Symmetry, or related population health platform system(s) Knowledge : Must be familiar with common database architectures and understand how to extract necessary data Must have strong proficiency in MS Excel (pivot tables, macros, lookups, etc.) and common analytic tools such as SAS, SQL, SPSS (writing queries, troubleshooting queries, extracting data, etc.) Knowledge about Medicare, Medicaid and Commercial Managed Care preferred Working knowledge of Healthcare Effectiveness Data Information Set (HEDIS) specifications and CAHPS survey requirements Knowledge of health care quality improvement processes and documentation Skills/Tools : At least 2 years of experience with SQL Server or Oracle At least 2 years of experience with SAS or R At least 2 years of experience with MS Excel At least 2 years of experience with Data Visualization in Excel, R or Tableau Experience with Oracle BI Answers a plus, not required Experience with MS Access a plus, not required Excellent written, verbal, presentation skills and inter-personal skills Strong clinical analytical and data interpretation skills Strong project management skills required; must be very organized and detail oriented Strong written and oral communication skills required; must be able to interact with all levels within an organization Abilities : Must be able to execute complex clinical analyses using sound epidemiological concepts and methodologies Must be able to produce requested analyses on a production schedule Ability to present analytical findings to leadership to enable data-driven decisions Must be able to interact with a variety of clinical operations SMEs to organize analytic plans and requirements for clinical analytic requests Ability to work in a collaborative, virtual team environment and analyze problems using a team approach Must be a team player and someone with ability to work with minimal guidance in fast-paced work environment. Ability to influence and manage a diverse set of stakeholders (clinical and nonclinical), both internally and externally Ability to think creatively to resolve common barriers and issues Ability to deal with ambiguity of ad hoc reporting requests, ask questions to seek clarification, and deliver results #MSTR
Professional Diversity Network
Detroit, MI, USA