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 Work
In this role, you will:
Be responsible for reviewing SQL/SAS/Python code of junior staff. Ability to work effectively with all levels of staff and adapt quickly to shifting and/or competing priorities. Healthcare knowledge with experience in supporting diverse Lines of Business (including Senior Markets, IFP, Dental, Vision, Life, etc) and Medical benefits required. Ability to work independently with limited supervision, interacting directly with business and IT counterparts to drive projects and initiatives forward. 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
Be adept at creating new reusable assets
Improve Member Understanding: Help BSC know members better by bringing together experience feedback, cost, quality of service, and network data to help LOB leaders understand their members better and make informed decision
Improve Member Retention: Utilize analytics expertise to find information in our data that can lead to an increase in member retention. Collaborate with business partners to solution and report from a retention outreach tracking system such as Pega or Salesforce. Identify and execute improvement opportunities to improve our Medicare Conversion rate. Conduct studies to identify the proper plans (cost/value/availability) to retain members
Improve Acquisition: Leverage data from Markets, Provider, Geo, Operations & other competitive intelligence sources to assist business partners in targeting and executing strategies that will drive membership growth
Ability to identify drivers of membership both internally and externally, as well as conversions from one product to another as customers transition through different life stages