Data Scientist, Medicare Analytics

Blue Cross and Blue Shield of Massachusetts, Inc.; Golden Horseshoe; Hybrid; CAD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a skilled Data Scientist to join their Performance Measurement and Improvement team. This role focuses on enhancing Medicare Stars ratings through advanced analytics and collaboration across various departments. The ideal candidate will leverage their expertise in data analysis and project management to drive improvements in consumer experience and care management. With a strong emphasis on teamwork and communication, this position offers an exciting opportunity to make a significant impact on population health initiatives. If you are passionate about data-driven decision-making and improving health outcomes, this position is perfect for you.

Qualifications

• 5+ years of experience in applied analytics or quantitative research.
• Advanced analytics methodologies supporting decision-making.

Responsibilities

• Collaborate with teams to quantify consumer-focused business issues.
• Conduct advanced analyses to develop analytic products.

Skills

SAS

R

Python

Data Analysis

Project Management

Communication

Problem Solving

Education

Degree in Statistics

Advanced Degree (MA/MS or PhD)

Tools

Data Analytics Tools

Job description

What We Need

As a core member of the Performance Measurement and Improvement team, the Data Scientist supports analytic activities related to BCBSMA's overall performance on Medicare Stars ratings, focusing on the CAHPS patient experience component. The role involves providing analytic support to identify efficient methods for maintaining and improving Medicare Stars clinical quality and patient experience metrics. This includes designing targeted interventions and projecting future performance scenarios, which will guide organization-wide quality and consumer experience initiatives.

The Data Scientist will also maintain, update, and refine analytic models through ongoing analyses and performance monitoring, assessing potential impacts on overall scores.

The successful candidate will have a proven track record in using advanced analytic techniques to derive actionable insights and integrate disparate data streams into cohesive views. Under the guidance of the Senior Director of Population Health Analytics, they will collaborate with teams across performance measurement, consumer experience, marketing, health management, and member services to define business needs and improve consumer experience and care management. The candidate must manage multiple projects, establish priorities, and communicate clearly and timely with stakeholders.

This role is available for our FLEX persona.

Day-to-Day Responsibilities

1. Collaborate with cross-functional teams (HMM, PMI, marketing, consumer services, IT) to quantify consumer-focused business issues and outcomes.
2. Translate business questions into analytic hypotheses, data needs, and reporting requirements.
3. Conduct advanced analyses to develop analytic products that meet business needs.
4. Develop targeted recommendations to enhance member and provider outreach, aiming to improve health outcomes and consumer experience among Medicare populations.
5. Generate and test hypotheses, mine data, and extract actionable results.
6. Create analytic dashboards to monitor performance metrics and forecast trends in Medicare performance.
7. Partner with technical teams to improve Medicare data infrastructure for analytics.
8. Present analysis results to decision-makers, including developing informative business metrics.

What We're Looking For

• Deep understanding of business operations, organizational goals, and processes; willingness to learn.
• Experience translating business needs into analytics plans and technical requirements.
• Experience working with large structured and unstructured data sets.
• Practical knowledge of advanced analytics methodologies supporting decision-making.
• Ability to independently manage projects with multiple stakeholders under deadlines.
• Skills to identify opportunities for productivity and efficiency improvements.
• Strong teamwork and problem-solving skills through communication and collaboration.
• Technical proficiency in SAS, R, Python, or similar tools for data analytics.
• Excellent written and verbal communication skills for presenting complex analyses clearly across organizational levels.

What You Bring

• Degree in statistics, econometrics, applied math, or related fields; an advanced degree (MA/MS or PhD) is a plus.
• At least 5 years of experience in applied analytics or quantitative research.
• Experience in applying analytics to improve population health, care management, and consumer experience.
• Experience supporting Medicare, especially Medicare Stars and CAHPS improvements, is strongly preferred.