Full-Time Senior Data Analyst

REQUIRED EXPERIENCE:

• Demonstrated knowledge of drug data file elements published by drug compendia/databases. Examples are, but not limited to ICD, Medi-span, Financial Bank (FDB).
• Familiarity with Pharmacy and non-Pharmacy Medicaid claims processing data inclusive of the Financial and Institutional data elements.
• Previous work experience with analyzing, monitoring healthcare plan data focusing on medical claim, data mining, and financial processing member eligibility processing, provider networks and Managed Care Organization (MCO) contract details, audit, and reporting in compliance with Federal and State requirements.
• Ability to create meaningful data presentations along with reports, including but not limited to hot-spotting, graphics, and other intuitive depictions of the data using Tableau.
• Proficient in SQL, data models, data element dictionary and schema, with the ability perform data business analysis.

JOB DESCRIPTION:

• Single Pharmacy Benefits Manger services for Ohio Medicaid Serves as a data analyst performing research and requirement analysis, creation and design of data specifications and mapping documents, and presents findings to team members, clients, and vendors.
• Work closely with engineers to deploy models to production both in batch and real-time while systematically tracking model performance.
• Build complex data sets from multiple data sources and write complex data flows using Databricks, SQL, Spark, and scripting languages (e.g., Python, R).
• Use data visualization tools (e.g., Tableau, PowerBI) to share ongoing insights.
• Present findings to both technical and non-technical audiences.
• Assist engagements with key business stakeholders in a discussion on business opportunities.
• Generate performance metrics such as accuracy, sensitivity, specificity, positive predictive value, ROG, AUG, calibration, SHAP (Shapley Additive explanations).
• Design, develop, test, validate, and deploy Machine Learning (ML) /Statistical models to not only learn from our vast amounts of data but to build new products.

What we're looking for (Top 5):

• Demonstrated knowledge of drug data file elements published by drug compendia/databases. Examples are, but not limited to ICD, Medi-span, Financial Bank (FDB).
• Familiarity with Pharmacy and non-Pharmacy Medicaid claims processing data inclusive of the Financial and Institutional data elements.
• Previous work experience with analyzing, monitoring healthcare plan data focusing on medical claim, data mining, and financial processing member eligibility processing, provider networks and Managed Care Organization (MCO) contract details, audit, and reporting in compliance with Federal and State requirements.
• Ability to create meaningful data presentations along with reports, including but not limited to hot-spotting, graphics, and other intuitive depictions of the data using Tableau.
• Proficient in SQL, data models, data element dictionary and schema, with the ability perform data business analysis.

Additional Skills/Experience:

• MS in Public Health/Public Health Administration or Computer Sciences - Statistics.
• SQL knowledge and experience working with relational databases, query authoring (SQL) as well as a proficiency with the SSRS Reporting tool and Tableau.
• Experience with Application and Data Analytics testing strategy and execution.
• Work with stakeholders including the Executive, Product, Data, and Design teams to assist with data-related technical issues and support their data analytics needs.
• Streamline existing and introduce enhanced reporting and analysis solutions that leverage complex data sources derived from multiple internal systems.
• Experience with Data mining, Data Science, and Predictive analytics is a plus.
• Knowledge of Payment Reform methodologies under the Affordable Care Act and related initiatives in the Medicaid space.
• Healthcare knowledge within a Medicaid / Healthcare plan claims processing environment.