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Resp & Qualifications
COMPANY SUMMARY:CareFirst, Inc., and its affiliated companies, generally referred to as CareFirst BlueCross BlueShield (CareFirst), is the Mid-Atlantic region’s largest private sector health insurer, serving the healthcare needs of 3.5 million members in Maryland, the District of Columbia, and portions of northern Virginia. The Company offers a comprehensive portfolio of products and services to individuals and groups, as well as state and federal government sponsored plans. With a market share almost three times that of the closest competitor, the company commands 45 percent penetration across the region. In July 2018, Brian D. Pieninck assumed the role of President and CEO after serving as the company’s COO of Strategic Business Units and IT Division. Under his leadership, the organization completed an extensive review of its operations and clinical programs, resulting in an expansive 3-year strategy to grow and diversify the company’s core business. Along with a 5-year vision to drive the transformation of the healthcare experience across the continuum of its members, partners, and communities, the company has placed a renewed and intentional focus on fostering a mission-based culture, which drives every decision the company makes. The organization employs over 5,600 full-time employees in Maryland, Northern Virginia, the District of Columbia, and West Virginia. CareFirst has earned multiple workplace awards recognizing its leadership in diversity and inclusion, wellness engagement, and creation of a supportive and equitable work environment for all employees.At CareFirst, you are part of an inspired, collaborative team that is building the healthcare experience we want for our families and our future. Every day, we make a meaningful difference in the communities where we live and work.We practice empathy, seek to understand, invest in inclusion, demand equity and nurture belonging every day for our employees and the communities we serve. We rely on the rich diversity of our employees’ experiences and backgrounds to achieve our mission. Every year we host a Week of Equity and Action where we deepen our investment and commitment to diversity, equity, and inclusion. During this week thousands of employees engage in workshops and volunteerism with the goal of bettering themselves and our community.- Women make up around 70% of CareFirst’s employee population, and over 50% identify as BIPOC (Black, Indigenous, and people of color).
- We have 9 resource groups that connect employees over shared identities (LGBTQ, veteran status, race, etc.) and passions (climate change, healthy living, leadership development).
- Employees are encouraged to give back and volunteer in their communities with their civic engagement hours.
- Development of automated data validation processes or infrastructure systems including self-service solutions or data lakes.
- Designing new data models or evaluating alternative logical data models.
- Creation and implementation of real time data stream dashboards and visualizations.
- Preparation and manipulation of data using multiple technologies.
- Experience with NCQA certified quality measure software (i.e. Cognizant’s Claimsphere or other standard quality measure programs (i.e. MIPS) or development of quality measure program scorecards.
- Data reporting and root cause analysis using clinical, claims, social determinants of health, census or other healthcare/economic/social conditions data that translate into actionable insights.
- Creation of data collection frameworks for structured and unstructured data.
- Working under minimal supervision and exercise discretion and independent judgement in the performance of assigned duties.
- Be responsible for orchestrating, deploying, maintaining and scaling cloud or on-premises infrastructure targeting big data and platform data management with emphasis on reliability, automation and performance.
- Lead the design and development of analytic methodologies and/or technical solutions that propel data-driven decisions for a wide variety of healthcare business functions of which some areas may include health services, government programs, general counsel and corporate security, core market and diversified benefits.
- Collaborate with multiple IT teams to drive technical design and solutions for report automation, visualizations, and self-service data delivery; and to adapt the architecture and assets from each to meet evolving business requirements.
- Lead projects from start to finish by interpreting the business needs of the request, translating those needs into time efficient analyses/solutions, delivering data in a consumable medium, and influencing leadership with actionable recommendations based on the findings.
- Use Agile approach that takes broad visions/concepts through an iterative process and develops innovative proof of concept products for data delivery.
- Make use of data, statistical and quantitative analysis, explanatory and predictive modeling and fact-based management to drive decision making and help customers develop new insights and understanding of performance-based data.
- Build corporate assets that align to the cloud-first, data-first architecture based on Agile development.
- See the big picture while focusing on the details when necessary.
- Provide thought leadership on best practices related to data modeling and analytics presentation.
- Build and maintain relationships with other cross-functional teams within IT and our internal/external customers to improve administration of healthcare business strategies.
- Work with business units and management to gather/understand business ideas for new customer centric reporting and self-service analytics.
- Graduated with a bachelor’s degree in Computer Science, Information Technology or Engineering or related field or equivalent combination of transferrable experience and education?
- Minimum 5 years with database design and developing modeling tools. Experience developing and updating ETL/ELT scripts. Hands-on experience with application development, relational database layout, development, data modeling.
- Worked with complex data environments moving and transforming data, performed data classification and translations, as well as resolving data quality and data cleansing challenges? Designed and/or used relational databases including experience working with dimensional modeling, star schemas and time-series data? Used programming languages including SQL, R, or similar stack? Knowledgeable with cloud data environments and data integration tools?
- Created visually appealing and interactive data visualizations that drive action within the business? Produced reports that tell stories with data? Ensure data accuracy by quality checking each analysis prior to publishing?
- Developed excellent research, analytical, written, and oral communication skills? Developed strong problem-solving skills? Worked independently and as part of a team? Developed the capacity to work with new technologies?