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Care Delivery Data Scientist
  • Data Analysis
  • Data Mining
  • Power BI
Blue Cross and Blue Shield of Kansas City
Kansas City, MO 64108
147 days ago

Are you interested in learning about healthcare professions and the latest healthcare innovations in the KC area? Become part of an organization that is dedicated to making a difference in both your career and community.


Job Description Summary :

The Care Delivery Data Scientist works closely with clients, data stewards, project/program managers, and other Spira Care and Blue KC teams to turn data into critical information and knowledge that can be used to make sound organizational decisions. The role will use creative thinking and propose innovative ways to look at problems by using data mining (the process of discovering new patterns from large datasets) approaches on the set of information available. They will need to be able to present back findings to the business by exposing assumptions and validation work in a way that can be easily understood by business counterparts.

Job Description

  • Collaborate and work closely with stakeholders to design and evaluate Spira Care clinical and provider-based reporting, trending and data analysis.
  • Participates in project development, design and evaluation to ensure the strategic directives of the stakeholders are executed and time sensitive deadlines met.
  • Provides analytical support for care delivery programs, including independently monitoring/measuring the performance of the initiatives by leveraging utilization, financial, clinical, member experience and benchmark data from multiple internal and external sources. Will perform analysis, summarize results, and oversee value-based payments while adhering to established standards and processes.
  • Applies robust and appropriate statistical and clinical rigor using advanced analytic techniques. Derives actionable insights from healthcare data (claims, clinical, pharmacy, externally sourced) to engage and support Spira Care and our providers. Support care delivery teams to deploy actionable insight into accessible solutions.
  • Present analytic findings and recommendations to non-technical business partners and leadership to drive data driven strategies.
  • Works collaboratively across Spira Care and Blue KC, including Medical Directors, Pharmacists, Medical Management, Population Health, Government Programs, and other areas to provide comprehensive and coordinated support to Spira Care.
  • Prepares analytic dashboards, reports and visualizations Power BI and other tools to provide insights and help stakeholders improve their performance
  • Develops and writes moderately complex executive summaries for reports related to analytic findings and opportunities for program improvements
  • Provide training, technical assistance and consultative guidance to team members and Spira Care Team. Drives cross pollination of best practices/best approaches and collaboration among internal and external stakeholders.
  • Explore innovative solutions to business questions/problems.

Minimum Qualifications

  • Bachelor's Degree or equivalent experience in Statistics, Biostatistics, Epidemiology, Health Outcomes Research, Healthcare Economics, Mathematics or Data Science
  • 5-7 years' professional experience
  • This position requires healthcare provider and/or healthcare insurance content knowledge, analytics/data science expertise to support Spira Care’s care delivery strategy.
  • Thorough understanding of value-based care and the role of primary and specialty care and health systems in directing care and delivering value within the healthcare ecosystem.
  • Working clinical knowledge on specialty conditions and deep understanding of health care and delivery system processes.
  • Strong Healthcare data knowledge and hands on experience (medical claims data, clinical data, pharmacy data and eligibility data)
  • Experience with analytical tools such as Business Objects and Microsoft Power BI
  • Experience creating impactful reports, visualizations, and interactive dashboards
  • Experience gathering manipulating and visualizing data
  • Ability to explain technical information in a simple way to non-technical audiences
  • Experience using Microsoft Windows, Excel, Word, PowerPoint and Access (or similar applications)

Preferred Qualifications

  • Advanced d egree or equivalent experience in Statistics, Biostatistics, Epidemiology, Health Outcomes Research, Healthcare Economics, Mathematics or Data Science

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