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Health Services Evaluator
Ref No.: 17-01849
Category: Health Information Management
Location: Rancho Cucamonga, California
We are seeking a Health Services Evaluator to work within the medical services division of a large Health Plan in California.
Health Services Evaluator
Job Summary:
  • Under the direction of the Clinical Research & Analytics Manager, the Health Services Evaluator will support the development, implementation and evaluation of intermediate to moderate levels of complex technical and analytical research and quality improvement projects to support the quality improvement efforts.
  • Responsible for modeling complex healthcare related problems, discovering insights and identifying opportunities through the use of statistical, algorithmic, mining and visualization techniques to support business decision-making.
  • Integrate and prepare large, varied datasets, architecting specialized database and computing environments, and communicating results; which are compliant with business rules and reporting requirement.
  • Serve as the project lead on moderately complex analysis/reporting projects and multi-departmental projects assigned to the Clinical Research & Analytics Unit.
  • Collaborate with staff at all levels to solve analytics issues, documenting results and methodologies.
  • Collaborate with the data steward to ensure that information used follows the compliance, access management, and control standards.
  • Plan and coordinate all aspects of major research programs across multiple clinical departments. Support inter-disciplinary, inter-institutional, and inter-sectoral research collaborations.
Qualifications:
  • Doctoral degree from an accredited university in Public Health and Health Care or related field is required.  Candidates with near completion of their Doctoral Degree in the field of Public Health, Health Care will be considered.
  • Minimum of 2 years of relevant quantitative and qualitative research and analytics experience with in-depth knowledge in manipulating large datasets, running queries, linking tables and generating reports.
  • The ability to establish solutions to loosely defined business problems by leveraging pattern detection over potentially large datasets.
  • Strong programming skills and statistical modeling (like SAS or R) with experience using machine learning algorithms.
  • Proficiency using statistical packages and in statistical analysis, quantitative analytics, forecasting/predictive analytics, multivariate testing, and optimization algorithms.
  • Demonstrate ability to think creatively and apply theoretical knowledge into practice.
  • Extensive utilization experience in Microsoft Access, SAS, ArcGIS and Excel are essential. Strong attention to detail.
  • Working knowledge of ICD-9/ICD-10/CPT/HCPCS/NDC medical coding, medical terminology and knowledge of managed care, claims payment processes and insurance terminology required.
 
Compensation:
  • Competitive pay rates!
  • Great Benefits!
  • Inquire for more details