Elevance Health - Denver, CO
posted 22 days ago
Full-time
Denver, CO
Insurance Carriers and Related Activities
About the position
The position involves developing and implementing clinical prediction models and statistical methodologies to enhance health plan functions. The role focuses on conducting statistical analyses and reporting to improve the company's competitiveness and profitability through effective program evaluation and experimental design.
Responsibilities
- Develops and implements prediction models for member and provider-based interventions.
- Conducts competitive analysis of risk stratification models and makes recommendations to management.
- Designs and executes care management program evaluations.
- Develops evaluation methodologies for measuring the effectiveness of clinical programs.
- Researches and analyzes broadly defined business scenarios, trends, and patterns and develops recommendations for management.
- Provides technical/analytical advice to staff.
- Responds to and manages ad hoc client requests to ensure accurate, in-depth results/data are delivered in a timely manner.
- Prepares results for presentation to internal/external clients.
- Presents research findings to management and clients.
- Compiles results of studies for journal publication.
Requirements
- MS in Biostatistics, Statistics or related field.
- 3 years healthcare and/or consumer data analysis experience.
- 2+ years experience in the development of predictive models.
- 3 years coding experience with SAS.
- 3 years experience manipulating and processing large multi-source datasets with SAS and SQL programming tools.
Nice-to-haves
- Experience with industry standard clinical code sets.
- Experience with predictive modeling risk adjustment tools and episode groupers and measures, such as HEDIS.
