Job Summary:

The incumbent will manage a team of analysts responsible for the development and production of healthcare and related analytics in a highly consultative manner. Provide data driven solutions in coordination with internal and external business partners that demonstrate improvements in population health and overall cost; health economic evaluation; external health partner performance; and population-based clinical, financial and quality business performance of various programs and services. Leads meetings with senior business leaders to ensure a data- driven, consultative analytics process is incorporated into sound business decisions.

Responsibilities:

• Manages, develops and trains staff; develops and monitors goals; conducts annual performance reviews, and administers salaries for the staff.

• Acts as the analytic team lead for complex projects involving multiple resources and tasks, providing individual mentoring in support of company objectives around identifying network, value-based model and deal performance.

• Supports the extraction of data from multiple sources for the creation of and creates integrated analytic datasets and creates reports and studies to address business questions.

• Understands the strategic direction of the organization and the analytic and reporting requirements to meet individual departmental needs. Participates in various departmental meetings to thoroughly understand needs.

• Navigates across multiple analytical and business units to socialize and gain buy-in for analysis design, results and interpretation, including making recommendations on how to use the results to refine value-based models.

• Ensures appropriate use of analytic tools and techniques to identify underlying drivers. Employs a data driven approach for retrospective review and predictive modeling.

• Provides meaningful analysis of data, interpretation of results, and appropriate reporting to senior and mid-level management throughout the organization. Incorporates metrics and benchmarks (both internal and external as appropriate).

• Develops, monitors and measures department policies and procedures to ensure analytic consistency. Employs appropriate techniques to ensure data integrity.

• Documents methods, specifications and findings clearly; contribute to writing and presentation of results, findings and conclusions to management and leadership. Ensures analysts document work appropriately, including use of Analytic Plan/Timeline where needed for Analytic projects.

• Prepares reports on medical costs and utilization to determine trend, risks, and opportunities related to medical and cost performance as needed.

Education/Experience:

• BA/BS degree from an accredited college or university in Analytics, Information Systems, Business, Economics, Finance, Mathematics, Computer Science, Public Health, Nursing, or a related field preferred.

• Requires a minimum of 5-8 years of experience in Analytics, Informatics, Medical Economics or other relevant work experience.

• Requires 2-3 years of management experience.

Knowledge:

• Requires understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management. Health Care provider or relating Consulting activities can be substituted for Managed Care experience.

• Requires proficiency with very large data sets (i.e. claims elements, membership, authorization, etc.) and software/coding (i.e. SAS).

• Requires knowledge of typical business objectives and strategies in care, utilization, and network management functions.

• Requires proficiency in MS Office (particularly Excel including formulas, calculations and graphs).

• Requires other database software experience with SAS experience a major plus.

• Requires technical skills with database concepts, data analysis development, data warehousing, and decision support tools.

Skills and Abilities:

• Requires proven quantitative and financial analysis skills.

• Requires the ability to express thoughts clearly and concisely, both verbally and in writing.

• Requires demonstrated ability to work in a team environment and get results in a consultative manner.

• Requires attention to detail and granular levels of analysis.

• Requires a demonstrated aptitude for analytical thinking and the ability to report findings in an accurate manner.

• Requires outstanding organizational skills including the ability to plan, organize, and prioritize work assignments.

• Requires computer with Microsoft Office products including XL, and other database software. SAS experience a plus.

• Requires technical skills with database concepts, data analysis development, data warehousing, and decision support tools; along with awareness of system development processes.

• Requires passion for validation of analyst work to ensure highest quality deliverables.

Salary Range:

$119,400 - $162,960

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.