Medical Informatics Analyst, Principal

Your Role

The AI & Analytics (D&A) team sits within the enterprise Growth organization, specifically aligned to the Risk Adjustment vertical. While situated within the Risk adjustment, this is strictly an advanced Medical Informatics and data architecture role. The Principal will serve as a critical semantic bridge and analytical lead supporting multiple Government Lines of Business (LOBs), including Senior Markets (Medicare Advantage, Medicare Supplement) and Individual and Family Plans (IFP/Covered CA). Reporting to the Sr Manager of Medical Informatics, this role is responsible for working with all the key leaders and stakeholders from Medicare, Med Supp, IFP and other Lines of Business and partner with Actuarial, Finance and others to be their AI & Analytics partner in achieving their Growth-related business objectives. This role requires not only analytical prowess but also a broad understanding of the business and business levers that matter in retaining and growing members. Being able to act as "two-in-a-box" with multiple business stakeholders is critical as you will be sharing the Membership Retention & Growth goals of the LoB's. You will work closely with business to understand & inform the BSC strategy around these goals, design & build smart analytic tools/reports to help business monitor the outcome of those strategies by leveraging current analytics capabilities & standing up new ones as needed, working with IT leaders cross-functionally.

The Medical Informatics Analyst, Principal must be adept at "translating" the business problem into an analytical approach, partnering with a of analytics professionals, and bringing in other specialties from within the D&A team such as data engineering, visualization, predictive modeling, and data governance as appropriate. The success of this role will hinge on the ability to quickly build trust with business partners & other stakeholders to achieve common goals. Utilizing analytics expertise and knowledge of systems such as Facets, Pega and Salesforce, you will analyze data to identify new opportunities for member retention and growth, conduct studies to understand the needs of members, and assist in the targeting of new member acquisition. You will bring together experience feedback, cost, quality of service, and network data to help Line of Business leaders know their members better and improve member retention and growth.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience

• Requires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent

• Requires at least 10 years of prior relevant experience

• Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)

• Ability to work effectively with all levels of staff and adapt quickly to shifting and/or competing priorities

• Healthcare knowledge with experience Medical benefits required

• Highly skilled in interpersonal and verbal/written communications, presentations, math, analytical and problem-solving, and the use of analytical tools

• Fluency with CMS Medicare data required

• High degree of fluency with PEGA , Salesforce and similar applications