Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Job Summary:

The Manager of Clinical Analytics is a managerial position requiring excellent leadership, communication, and data analytics technical skills. The position is a key team member collaborating in a multi-disciplinary business environment with colleagues across the enterprise to support clinical performance analytics, development, and reporting that deliver actionable clinical insights to providers and health care value to members and employer customers.

As a subject matter expert, the Mgr., Clinical Analytics designs analytic plans, manipulates, analyzes, and interprets large healthcare data from various data sources to inform the solutions that improve clinical quality and increase cost efficiency and health care affordability. This position requires sound analytic programming skills with a robust knowledge and understanding of the healthcare business and data.Responsibilities:

Acts as the analytic team lead for complex clinical analytics projects involving multiple data resources and teams to inform business decisions in clinical, network, value-based payment models, and employer engagement.

Understands the strategic direction of the organization and the analytic and reporting requirements to meet departmental needs. Translates business questions and needs into analytics technical requirements including data analytics design, clinical and data specifications, and reporting format.

Leads the design and extraction of data from multiple sources. Creates integrated analytic datasets. Performs analytics and summarizes findings to inform business opportunities and address business questions.

Provides insight and guidance into analytic findings (including root causes and contributing factors – both actionable and not) through clear, professional, succinct written and oral summaries, tables, charts, reports, or presentations.

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 inform business decisions.

Ensures appropriate use of analytic tools and programming techniques for analytics efficiency.

Builds quality assurance criteria to ensure data and analytics results accuracy and consistency.  

Documents methods, specifications and findings clearly. Contributes to writing and presentation of results, findings and conclusions to management and leadership. Ensures analysts document work appropriately, including SAS coding comments and use of analytic plan/timeline where needed for analytic projects.

Manages, develops and trains a team of 3-5 staff members. Develops and monitors goals, and conduct annual performance reviews. Ability to manage a growing team and drive a culture that supports our mission, vision, and strategy. 

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Education/Experience:

High School Diploma/GED required.

Bachelor degree preferred in Math, Statistics, Data Science, Economics, Epidemiology, Public Health, or related field or relevant experience in lieu of degree.

Requires a minimum of 5 years’ experience in Data Analytics, Informatics, Medical Economics or other relevant work experience.

Prefers a minimum of 5 years working experience of visualization and BI tools (e.g., Tableau, Power BI.) with preference given to Tableau experience.

Prefers demonstrated hands-on experience of clinical episode groupers and analytics, preferably with Optum’s Symmetry Suite of Services (Impact Intelligence, ImpactPro, ETG, ERG, PEG, EBM, PRG, etc.).

Requires a minimum of 5 years experience performing analysis on large healthcare administrative claims data, EHR/EMR data, or complex relational health care databases with significant experience analyzing medical, pharmacy, and behavioral health claims data.

Requires a minimum of 5 years experience programming in SAS.

Prefers 3 years of supervisory experience; acceptable alternatives include successful examples of leading and influencing colleagues or peers, leading a strategic project, significant experience in the functional roles on the team, and/or completing a leadership development program or certification. 

Prefers experience of statistical tests and modeling.

Knowledge:

Requires extensive knowledge of US healthcare industry, claims data, clinical data, coding practices.

Skills and Abilities:

Proficiency with MS Excel for data analysis and reporting.

Solid organizational skills and attention to details.

Strong ability to work in a fast-paced team-oriented environment.

Strong ability to manage competing priorities.

Highly motivated and able to work independently.

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