Senior Decision Support Analyst

highmarkhealth; Pittsburgh (Allegheny County); Hybrid; USD 110,000 - 160,000; Full time

Job summary

Highmark Inc. is seeking a skilled Analyst to develop and deliver advanced analytics that inform contract negotiations, unit cost management, and key business decisions.

The role requires building complex financial and utilization models, translating data into actionable insights, and assessing reimbursement structures across provider arrangements. The candidate should understand DRGs, APCs, RVUs, case rates, and episodic payment models, with experience communicating findings to both technical

Qualifications

• Bachelor's degree in Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research, or related field
• 5 years of relevant, progressive experience as a Decision Support Analyst or equivalent

Responsibilities

• Develop and foster internal relationships across the corporation and provide analytic support to internal customers
• Mentor colleagues on technical and business aspects of projects
• Define issues and study approaches; create or adapt methods of analysis, database design and performance measurement
• Model data sources and flows; define an operational framework for data security and knowledge delivery
• Interpret raw data and statistical results; prepare written reports or oral presentations for internal and external audiences

Skills

Mainframe/PC tech

Office reporting tools

Communication skills

Education

Bachelor's degree in CS/Math/Stats

Master's degree preferred

Tools

SAS

R

SQL

DB2

Teradata

Oracle

Job description

Company

Highmark Inc. Job Description :

Job Summary

This is a hybrid role requiring onsite presence three days per week. Pittsburgh, PA is the preferred location; however, other locations may be considered. This position partners closely with contracting, provider reimbursement, actuarial, and senior leadership to develop and deliver advanced analytics that directly inform and support contract negotiation strategy, unit cost management, and key business decisions. The role is responsible for independently building and interpreting complex financial and utilization models, translating data into actionable insights, and evaluating the impact of reimbursement structures across provider arrangements. Additionally, this role will proactively identify cost drivers, assess financial risk, and develop scenario-based analyses to guide strategic direction.

The successful candidate will possess a strong understanding of healthcare reimbursement methodologies (e.g., DRGs, APCs, RVUs, case rates, and episodic payment models) and payer policies, including familiarity with Medicare and Medicaid. This role requires advanced analytical and problem-solving skills, with the ability to synthesize large, complex datasets and clearly communicate insights and recommendations to both technical and non-technical audiences.

ESSENTIAL RESPONSIBILITIES

• Develop and foster internal relationships across the corporation. Provide analytic and consultative support to a broad spectrum of internal customer areas and external business partners.
• Mentor colleagues with less experience on both the technical and business aspects of project and consultative work.
• Determine how decision support systems will provide information required to make effective business decisions, translate requirements into applications that employ appropriate decision support and reporting tools. Use broad experience and technical knowledge to propose solutions to complex business problems. Take the lead in driving the implementation of the recommended solutions.
• Take the lead in defining issues and ideas to be studied as well as the approach (methodological and technical) to be used in addressing studies and projects. Create and/or develop new methods of analysis, database design, and performance measurement or, in some cases, adaptation of existing solutions to new areas.
• Perform modeling of data sources and flows, work with data management staff to define an operational framework that will define, develop, and implement policies and security frameworks to ensure precise and secure deliver of knowledge and information.
• Provide assistance and, depending on skill and experience, lead with interpretation of raw data, statistical results or otherwise compiled information, identify follow-up action items, and prepare or assist in the preparation of written reports and/or oral presentation of findings to internal and external audiences, customer managers, clinical staff, compliance agencies, group accounts, providers, agent plans, and brokers.
• Develop and maintain moderate-to extremely-complex computer programs using 4GL programming languages (such as SAS, R, SQL) and other database technology (DB2, Teradata, and Oracle).
• Other duties as assigned or requested.

Education

Required

Bachelor's Degree in Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research, or related field

Substitutions None

Preferred

Master's degree in or related to Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research

Experience

Required

5 years of relevant, progressive experience as a Decision Support Analyst or equivalent training and experience in a business or clinical environment with direct responsibility for applying technology

Preferred

None

Skills

• Strong technical skills in the mainframe, PC and Internet-based technologies to be effective and must be comfortable and proficient using large and complex databases
• Strong skills using various third-party office and report generation products such as Microsoft Office, Business Objects, Cognos, and Enterprise Guide.
• Strong communication skills. Must be comfortable presenting findings and offering recommendations to senior management

Language (Other than English): None

Travel Requirement: 0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

• Position Type Office-based
• Teaches / trains others regularly Never
• Travel regularly from the office to various work sites or from site-to-site Never
• Works primarily out-of-the office selling products/services (sales employees) Never
• Physical work site required Yes
• Lifting: up to 10 pounds Constantly
• Lifting: 10 to 25 pounds Occasionally
• Lifting: 25 to 50 pounds Never

Disclaimer: The job description has been designed to indicate the g