Job Information
Independence Blue Cross, LLC Senior Research Analyst (Pharmacy) - 240613 in Philadelphia, Pennsylvania
Senior Research Analyst (Pharmacy) - 240613
DESCRIPTION/RESPONSIBILITIES: Major Responsibilities: * Responsible for working with health insurance claims and membership data to complete research and analysis related to delivering quality health care. Managing monthly data refreshes that drive reporting across the company supporting providers, members, employer groups, and other internal analysis. * Involvement with the development and UAT processes of our provider portal. Working with the technical team to implement our team's queries into an automated application and assuring resulting reports and dashboard visuals are accurate and effective. * Working with our Provider Experience team to execute programs to assist in making sure members are completing appropriate preventative care screenings. Creating member outreach lists based on program specifications, analyzing impact of outreach efforts, and trending performance improvements year over year. * Working in collaboration with team leads to provide analytical, reporting and project implementation support to internal clients * Provide analytical support for corporate initiatives and develop innovative solutions for more effective provider reporting and clinical programs. * Develop reporting using claims, membership, and provider data in support of Informatics analytical projects * Analyze and condense complex claims, authorizations, pharmacy and membership data into meaningful summaries * Summarize, interpret and present results in a clear, concise manner for internal and external clients * Interpret utilization and medical cost trends and investigate abnormalities; compare to industry trends/benchmarks
Qualifications - External * Bachelor's degree in mathematics, finance, public health, nursing, epidemiology, health care, statistics or related quantitative area. Prior industry experience a plus but not required. * Knowledge of SQL / R programming skills with emphasis in large datasets required * Experience with advanced reporting tools such as SSRS and Tableau preferred. * Experience analyzing large datasets, demonstrable technical experience and data management skills including data extraction, data scrubbing and data transformation with an emphasis on the ability to perform QA and reasonableness checks * Willing to work in a team atmosphere and to collaborate with others * Background in healthcare data preferred * Independently motivated to drive projects forward * Excellent oral and written communication skills
REQUIRED SKILLS: Hybrid Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
Equal Opportunity Employer-minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity