Healthcare Claims Data Analyst

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Department Summary:

MITRE is seeking experienced healthcare claims data analysts with the ability to develop expertise in quality improvement, performance measures, policy development, care delivery process improvement, payment modeling, health IT, stakeholder engagement, or program implementation to support the Centers for Medicare and Medicaid Services (CMS) through all phases of healthcare modernization and transformation.

The candidate best suited for the position will thrive in a highly dynamic environment, easily performing independent work, as well as working comfortably in team settings. This position requires significant experience with CMS claims data and the ability to design studies and analyses, interpret and present findings through high level skills in critical thinking, database queries, data analysis, data modeling, and data visualization. The position provides an exciting opportunity to make a substantive impact in the areas of health care quality, federal policy, and alternative models of healthcare payment. 

Roles & Responsibilities:

• Apply specific subject matter knowledge to achieve project objectives and to contribute to impactful outcomes.
• Lead and contribute to planning and design of claims-based analytical research and studies
• Design and perform analyses in multiple environments including the CMS IDR and CCW
• Ensure PII and PHI redaction to create less-sensitive datasets and exhibits.
• Assist with analysis in support of federal health program implementations.
• Develop technical products such as data analysis, data visualization, briefing papers, and strategic recommendations to support program development and strategic decision making for the advancement of health outcomes.

Basic Qualifications:

• Typically requires a minimum of 8 years of related experience with a Bachelor’s degree; or 6 years and a Master’s degree; or a PhD with 3 years’ experience; or equivalent combination of related education and work experience.
• Extensive knowledge of CMS claims data, in either the IDR or CCW environment or with CMS Limited Data Set (LDS) Analytic files is required including Inpatient, Outpatient, Skilled Nursing Facility, Home Health Agency, Hospice, Carrier, Durable Medical Equipment, Prescription Drug Event (PDE), and Medicare Advantage Encounter claims.
• Degree in a data related field (e.g., computer science, management science, information technology, statistics), public health, medicine or healthcare, healthcare policy, public policy, social science, economics, or related field with 8 or more years of experience.
• Advanced SAS and PROC SQL code development and data retrieval skills for operation in CMS data environment.
• Proficiency in understanding and writing SQL queries for data analysis and retrieval from other databases and system.
• Excellent written and oral communication skills, including the ability to clearly communicate analyses and findings to various stakeholders
• Strong consulting skills, including the executive presence needed to work directly with senior government representatives and the ability to collaboratively work with interdisciplinary MITRE team members.
• Ability to juggle multiple projects simultaneously in a fast-paced environment and ability to work successfully in ambiguous situations
• Demonstrated strategic and analytical thinking skills.
• Ability to create high quality work products with excellent attention to detail.
• Ability to lead project tasks and to mentor junior staff.
• This position requires a minimum of 50% hybrid on-site

Preferred Qualifications:

• Knowledge of additional analytical programming languages (e.g., R, Python)
• Experience with data visualization tools(e.g., Tableau)
• Experience with SAS Enterprise Miner or other Machine Learning/Artificial Intelligent tools and programming languages
• Examples of authored code (as appropriate)
• Sample data-focused publications (if applicable)
• Cover Letter addressing your interest in the role and relevant skills pertaining to the job description

This requisition requires the candidate to have a minimum of the following clearance(s):

None

This requisition requires the hired candidate to have or obtain, within one year from the date of hire, the following clearance(s):

Suitability – HHS

Work Location Type:

Hybrid

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