

Detroit, US-MI

Blue Cross Blue Shield of Michigan


keywords: analysis,analysis,research,prepare,medical,support,knowledge,presentation,management,degree,experience,analysis


Competitive Compensation and Benefits Package

Overview: Involved in advanced analytics in support of conceptualization, design and evaluation of BCBSM clinical programs, such as the largest Patient-Centered-Medical Home initiative in the nation and numerous pay-for-performance initiatives.
Responsibilities: <ul> <li>Analyze large volume of health care administrative data using advanced statistics/data mining methods to understand existing and predict future health care spending trends and issues.&nbsp;</li> <li>Proactively discovers potential areas for medical cost improvement and management/healthcare initiative strategies.</li> <li>Responsible for research, analyze and recommend topics within scope of internal desk audit, including the specifications.&nbsp;</li> <li>Provide statistical support and consultation to auditors, legal services, CFI, etc. on sampling and projections, and provider aberrancy and use patterns.&nbsp;</li> <li>Prepare presentations and technical reports in a clear and concise manner to communicate findings from epidemiologic studies to management, Michigan providers and other interested parties.&nbsp;</li> <li>Disseminate research results through presentations to scientific and professional groups and through publications in scientific and professional journals.&nbsp;</li> <li>Identify potential problems through data information review, analyze and investigation from massive data files.&nbsp;</li> <li>Other duties may be assig</li> </ul>
Requirements: <ul> <li>Master's Degree in Statistics, Biostatistics or Health Economics.</li> <li>At least two (2) years experience in statistics, biostatistics or health economics.</li> <li>Extensive knowledge of advanced statistical methods used in analyzing health care data and in data mining.</li> <li>Extensive knowledge of health insurance and health care industry in general and specifics about BCBSM business, products and programs.</li> <li>Must possess a working knowledge and understanding of how physicians and other providers practice can vary.</li> <li>Ability to write reports for internal and external customers.</li> <li>Knowledge of statistical experience for audit sampling and projection with ability to explain statistic findings to non-statistician individuals and to defend the statistics in a legal setting.</li> <li>Ability to function independently, manage multiple tasks and work effectively under minimal supervision.</li> <li>Working knowledge of PC and mainframe applications and computer systems.</li> <li>Ability to present and defend work findings and decisions under the stress of conflict and challenges while maintaining a professional image.</li> <li>Strong analytical, organizational, verbal and written communication skills.</li> <li>Strong working knowledge of data languages such as SAS or SQL.</li> </ul>