Senior Healthcare Infomatics Analyst

We are seeking a highly skilled Senior Healthcare Informatics Analyst to independently provide analytics aimed at understanding and improving how healthcare is valued, utilized, and delivered. This role focuses on developing analytic attributes related to patient-level health utilization and outcomes, provider performance, risk-adjusted revenue optimization, medical cost management, and patient/provider engagement behaviors. In collaboration with IT and other business areas, you will lead problem solving, solution development, strategic planning, and decision-making initiatives. This position requires strict adherence to all applicable healthcare laws and regulations. Key Responsibilities Lead selection of evaluation, analytics, and BI methodologies; communicate recommendations to support strategic planning and decision-making. Leverage in-house clinical reporting software, Enterprise Data Warehouse (EDW) data, and other non-EDW data sources. Independently facilitate business development and create analytic solutions such as predictive models, BI solutions, or analytic attributes. Serve as an analytics advisor to collaborating departments across corporate and cross-functional projects. Translate business rules into analytical models; act as a liaison between healthcare analytics, IT, and business areas. Perform descriptive and advanced analytic/statistical studies, including predictive modeling. Conduct peer data quality reviews to ensure accuracy, completeness, and consistency of outputs. Maintain effective collaboration with Clinical Solutions, Clinical Partnerships, Actuary, Provider Reimbursement, Payment Innovation, IT, Marketing, external vendors, Blue Cross Blue Shield Association, and other BCBS plan partners. Qualifications Education: Bachelor’s in Healthcare Administration, Statistics, Economics, Analytics, or Computer Science required. Master’s degree in a related field preferred. Four years of related experience may substitute for a Bachelor’s degree. Experience: 4+ years of healthcare, analytics, IT, or management consulting experience. Experience with Medicare Advantage is preferred. Master’s degree may substitute for two years of required experience; doctorate may substitute for an additional two years. Skills & Knowledge: Strong critical thinking, analytical, and problem-solving skills. Experience building predictive models. Knowledge of outcome research design and controlled study design preferred. Advanced SAS skills, including Enterprise Miner, preferred. Strong familiarity with SQL, SAS, R, Python, Tableau, or similar analytic/visualization tools. Knowledge of U.S. healthcare delivery systems, provider payment methodologies, population health management, and risk adjustment concepts. Understanding of clinical groupers (DRG, APC, ETG, MEG, DxCg, HCC) and quality metrics (HEDIS, AHRQ) preferred. Ability to consolidate and communicate complex technical topics to all levels, including executives, business and technical managers, and external vendors. Licenses/Certifications: None required. Additional Information This position does not manage direct reports. Work is performed primarily in a clean, office-like environment (remote), with the ability to sit or stand as needed. Reasonable accommodations may be made for individuals with disabilities. Eligible Hiring States Due to business and regulatory requirements, candidates must reside in one of the following approved states to be considered for this position: Alabama Arkansas Delaware Florida Georgia Idaho Indiana Iowa Kansas Kentucky Mississippi Missouri New Hampshire Nebraska North Carolina Oklahoma Pennsylvania • South Carolina South Dakota Tennessee Texas Utah Virginia West Virginia Wisconsin • Pennsylvania applicants are eligible except those residing in the following counties:Allegheny, Bucks, Chester, Delaware, Montgomery, and Philadelphia. Pay: $50.00 - $52.00 per hour Work Location: Remote