CareFirst Careers

Data Analysis Consultant

Resp & Qualifications

The Data Analysis Consultant role is a unique opportunity for someone passionate about leading and participating in the development, validation and delivery of algorithms, statistical models and reporting tools, as well as solving complex analytical issues. This individual leads the creation of cutting-edge analytic tools to drive better and faster decision making within the organization and provides critical support for key corporate programs, Medicare Advantage Stars and Risk Adjustment programs. This role will require frequent interaction with project stakeholders and business partners at all levels throughout all divisions of the organization. This position will use predictive and behavioral analytics, and analytically derived insights to develop and test solutions that enhance consumer engagement, improve health outcomes in clinical care and member experience to optimize Medicare Advantage plan performance. This is a fast-paced, collaborative, matrixed and iterative environment requiring quick learning, agility and flexibility.

PRINCIPAL ACCOUNTABILITIES:  Under the direction of the Vice President of Quality, Stars and Risk Adjustment and Director of Quality, the principal duties and responsibilities include, but are not limited to, the following:

The incumbent supports enterprise Stars and Risk adjustment strategy through collaboration with analysts, healthcare policy makers, and strategy leaders throughout the company to identify trends and opportunities across the Medicare and Medicaid healthcare landscape. This person will consult with business leaders, IT partners, and product owners to facilitate product development and guide Stars and Risk Adjustment priorities through insightful analytics.

This may include some or all the specific skills and functions below:
• Communicate predictions and findings to all associates throughout the company, including executive management through effective data visualizations and reports.
• Strategic thinker that can take broad visions and concepts and develop structured plans, actions and measureable metrics and then execute those plans.
• Conduct undirected research and frame open ended questions. Work with business units and management to gather/understand requirements for new business solutions.
• Build sophisticated algorithms to meet business solution requirements and use statistical, mathematical, predictive modelling, machine learning and artificial intelligence skills to build a comprehensive platform for data analysis and reporting.
• Analyze data to discard erroneous or problematic information.  Explore and examine data from a variety of angles to determine hidden weaknesses, trends or opportunities in the data. Provide analytical commentaries to explain or highlight significant findings.
• Design and develop analytic methodologies for multiple projects on a wide variety of Stars and Risk Adjustment issues.

Identify and quantify key drivers for the Risk Adjustment and Quality/Stars programs, investigate areas of opportunity, evaluate effectiveness and make recommendations. Apply business knowledge to Analytics projects and provide value-added insights to impact business outcomes, working cooperatively with various internal and external partners.
Using the application of sophisticated analytical capabilities, develops and maintains visualizations to support all business divisions across all levels. Develop and maintain scheduled and ad hoc reports for Risk Adjustment and Quality in response to business needs given tight deadlines, minimal direction, and shifting priorities.

Provide on-going tracking and monitoring of application performance and recommend improvements to methods and algorithms. Work closely with clients, data stewards, and other business and technology leaders to frame problem definition and potential solutions. Required to stay current with Government Programs requirements and directives including those specific to Medicare and Medicaid and update all their reporting and analytics accordingly. Work with external vendors and governmental agencies as required. Excellent organizational skills and ability to set priorities and handle multiple projects concurrently.  

Other duties as assigned in support of Quality, Stars and Risk Adjustment business deliverables. 

Incumbent is expected to be experienced working with structured and unstructured data to create visualizations that  are meaningful for all levels of the organization utilizing extensive statistical and predictive methodology knowledge and application of best practices to ensure accurate tracking of Stars predictions, identification of areas for improvement, and sharing of next best action considering individual member considerations such as social determinants of health, racial and ethnic characteristics, and member preferences that impact the likelihood of engagement.
The incumbent is also expected to independently plan, organize, and prioritize assigned projects, creating and managing work plans that reflect the tasks, timeframes, and processes required to successfully complete each.
Minimum Qualifications:
• Bachelor's degree in Data Science, Mathematics, Computer Science, Statistics, or a closely related field or equivalent combination of transferrable experience and education
• 7+ years of experience in data science methodologies, data analysis, modeling and reporting

• Expert programming experience with R, SQL, SAS, Python or similar stack
• Proficiency at transforming data, data classification and translations, as well as resolving data quality and data cleansing challenges
• Business knowledge of government programs (Medicare Advantage and Medicaid) healthcare data and systems
• Independent decision-making and critical thinking skills
• Sophisticated analytical capabilities and the development and maintenance of visualizations to support all the business divisions across all level
• Excellent research, analytical, written and oral communication skills
• Strong problem-solving skills
• Ability to work independently and as part of a team
• Willingness to work with new technologies
• Intermediate design work and/or use of relational databases including experience working with dimensional modeling, star schemas and time-series data
• Demonstrated proficiency with visualization tools such as Power BI Service and Tableau
• Experience working with unstructured data such as social determinants of heath, electronic medical records, clinical data, or similar

• Masters or Phd in disciplines identified above
• Experience working with Azure Cloud native programs
• Agile software development experience
• Experience with large data sets and distributed computing (Hive/Hadoop) a plus

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 3.7.21

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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