Data Scientist – Quality and Population Health
Description:
• Applies rigorous data science principles and methods to continuous quality improvement and methodical evaluation of HEDIS and Population Health interventions
• Synthesizes salient data analytics to craft actionable data stories that highlight successes, opportunities, and recommendations for performance improvement by HEDIS measure and subpopulation level
• Leads data science infrastructure development and automation via SQL, Python, Excel, R, Power BI, and additional tools
• Leads development of custom analytics to meet regulatory requirements (e.g., Quarterly Business Reports, Annual Reports, RFP)
• Leads rigorous evaluation research into prioritized Medicaid population health interventions end-to-end (research design, methodology, analysis, presentation, continuous improvement cycle)
• Leads the development of fact/dimensional data models within Power BI that serve evaluation research effort
• Leads all data science efforts to continuously monitor HEDIS and population health performance metrics using appropriate methodologies
• Leads KPI design, Power BI data modeling, custom algorithms, machine learning, and continuous quality improvement techniques
• Leads project management and communication of multi-month, cross-functional data science infrastructure projects
• Leads in-depth program evaluation analytics to understand successes and opportunities within Population Health Management Programs
• Leads custom data insights generation for senior leadership and regulatory/accreditation reporting (e.g., Illinois Department of Healthcare and Family Services, NCQA)
• Leads iterative development of actionable, custom-built Power BI solutions for frontline staff and senior leadership
• Transforms manual data intake and reporting efforts into standardized, automated processes that monitor and flag data validity, accuracy, and completeness issues
• Effectively communicates data insights to key stakeholders with varying data skills
• Trains fellow analysts and colleagues in advanced data science principles, Power BI, SQL, Python, R, Hadoop, and data visualizations
• Trains colleagues on how to use and interpret custom-built Power BI solutions
• Other duties as needed
Requirements:
• At least 5 years of experience within the analytics industry
• At least 3 years of demonstrated healthcare analytics experience within Medicaid/Medicare space
• Advanced knowledge of data science principles and techniques (e.g., inferential statistics, machine learning, algorithms, data modeling, statistical significance testing, forecasting)
• Advanced knowledge of identifying appropriate data science methods based upon the existing data and research questions
• Advanced knowledge of evaluation research, longitudinal trending, and population monitoring to demonstrate effectiveness of interventions
• Advanced knowledge of effectively communicating data verbally and visually to data experts as well as non-data experts
• Advanced knowledge of data-appropriate visualization techniques (bar, line, scatter, boxplot, choropleth map, heatmap, matrix table, decomposition tree, pareto, histograms)
• In-depth experience in RFP work and generating evidence-based data stories for quarterly/monthly reporting
• Advanced knowledge of healthcare data types (qualitative, quantitative, geospatial)
• Advanced knowledge of SQL and writing SQL code within SQL Server Management Studio
• Advanced knowledge of relational database design including fact-dimensional data modeling
• Advanced knowledge of Power BI (e.g., DAX)
• Advanced knowledge of Microsoft Excel (formulas, pivot tables/graphs, data slicers, statistical toolkit)
• Advanced knowledge of designing and evaluating KPIs, outcome measures, and other custom-built metrics
• Advanced knowledge of population analytics (Dx, med econ profiling, SDOH, utilization pattern, CPC, ICD-10, HCPCS) and profiling techniques
• Advanced knowledge of HEDIS and other healthcare data industry standards, issues, and trends
• Ability to curate data to ensure that it is valid, accurate, and complete
• Ability to work efficiently within Microsoft 365 environment (Teams and SharePoint)
• Ability to independently plan and execute data analytics requests within cross-functional teams
• Ability to prioritize multiple data requests within a fast-paced environment
• Exceptional attention to detail, critical thinking, and data communication skills
• Exceptional ability to convey complex information in simple, effective ways and craft evidence-based data stories
• Demonstrates a positive attitude and works efficiently to ensure that deadlines are met
• Bachelor’s degree in Data Science, Analytics, Computer Science, Math, Psychology, Statistics, Sociology or equivalent experience (Master's degree preferred)
• Preferred qualifications: Python, R, Hadoop
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• Eligible for a CVS Health bonus, commission or short-term incentive program
• No-cost programs including wellness screenings, tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
• Other benefits depending on eligibility
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