Senior Medical Informatics Research Scientist
Blue Cross & Blue Shield of FL (Jacksonville, Florida)

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Our innovative Medical Informatics Department leverages technology and informs the business through Six Sigma process integration. Blue Cross Blue Shield of Florida is currently receiving resumes for future employment opportunities as a Senior Informatics Research Scientist in our Medical Informatics Department.

Job duties include but are not limited to the following:
• Provide technical and clinical leadership to develop and utilize predictive modeling algorithms and automate systems to proactively identify population segments that are statistically more likely to require disproportionate amounts of healthcare resources
• Proactively collaborate with Medical Management to determine which identified population segments might benefit from certain care programs
• Proactively collaborate with Medical and Network Management to develop actionable provider specific information to enable the identification of undesirable performance patterns related to quality, use, cost and other variables.
• Lead the analytic team in ensuring that there is a continuous assessment and improvement of methodologies and tools to support current and emerging business process needs
• Utilizing advanced statistical techniques, develop routine assessments of provider and network performance (clinical & financial) to support care, quality, network, and pharmacy business processes
• Develop original algorithms and implement in systems and tools that will be used to develop new predictive models and provider profiles that go beyond standard industry tools and lead to innovative solutions to address cost and use of medical benefits
• Determine the continuous improvement opportunities of current predictive modeling algorithms used in the member identification & categorization process and provider performance assessment capabilities and develop new statistical methodologies to increase predictability
• Provide high-level controllership/ evaluation of all data produced to ensure established targets are met. Integrate with Medical Cost Analysis team on key investigative initiatives
• Integrate advanced statistical techniques into Informatics tools with the Information Technology Medical Informatics (ITMI) team. Supervise, coach, and develop team.
• Utilizing industry standard tools (ETGs, CRGs, etc.) and predictive modeling techniques, determine appropriate member identification and categorization algorithms and processes, which support case and disease management, population assessments and other Delivery Systems core processes

Job Requirements:
• Doctoral Degree in Biostatistics, Statistics, Mathematics, Epidemiology or equivalent training and mastery
• Minimum 10 years experience in related health care analytics
• Demonstrated experience in population identification, interventions, profiling, outcomes evaluations, and predictive modeling, to include experience with neural net and artificial intelligence
• Proficient in advanced data and statistical techniques and study designs commonly used in epidemiological and health services research
• Demonstrated leadership competencies with the ability to collaborate with others and establish working relationships, communicate effectively across the organization and at different levels, coordinate multiple work efforts, and translate business needs into practical applications and solutions
• Demonstrated experience in managing the design, development, and continuous improvement of complex healthcare data systems, tools, and reports
• Strong analytical, creative problem solving and project management skills
• Strong customer focus and management of client expectations
• Experience in large complex systems, including a solid background in effective use of multiple environments (PC, server, mainframe, intranet)
• Intermediate to Advanced knowledge of systems and computer programming
• Demonstrated understanding of health care and delivery system oriented business processes
• Knowledge of Six Sigma methodologies and concepts

Please Apply Here