Aetna Lead Data Scientist in Hartford, Connecticut

Req ID: 43658BR

POSITION SUMMARY

Aetna's Provider Analytics Team delivers analytics which are the foundation for our enterprise strategy. We build analytic solutions that integrate diverse internal and external datasets within a cutting-edge Hadoop parallel-processing environment. We are currently seeking an Analytics Manager in our New York, NY location focused on Medicare Fee For Service (MFFS) provider quality and performance analytics. This manager will:

Be the analytic team lead for large and complex projects involving multiple resources and tasks in support of company objectives.

Manage and be responsible for the successful delivery of MFFS provider profiling analytics and reporting through the creation, application, and management of clinical quality and provider efficiency metrics for both PCPs, specialists, and facilities

Leverage algorithms, statistical models and reporting tools to meet business needs

Act as Subject Matter Expert on the Medicare 5% or 100% claims sample, effectively interacting with users across the organization to ensure that the data is utilized properly to address business needs.

Fundamental Components:

Collaborate with business partners to understand needs, align on appropriate technical approaches to address them, align on delivery timeline, syndicate results and/ or drive adoption of new or enhanced technology/ business solutions

Interact with internal and external peers and management to share highly complex information related to areas of expertise

Manage large and complex analytical projects end-to-end, including data exploration, model building, performance evaluation and testing:

Determine most appropriate analytic approaches and modeling techniques to evaluate scenarios and potential future outcomes

Perform analyses of structured and unstructured data to solve multiple and complex business problems utilizing advanced techniques and specialized expertise in the organization and/or industry

Behave as mentor to junior team members, to provide technical advice.

BACKGROUND/EXPERIENCE:

*5-7 years - relevant health care analytical experience

  • Experience with health care industry episode groupers

  • 3-5 years - provider profiling and benchmarking for both efficiency and quality metrics

  • Familiarity with HEDIS quality metrics a plus

  • 3-5 years - Medicare FFS 5%, 100%, or LDS claims

  • Experience with beneficiary file, inpatient, and outpatient claims key

  • Familiarity with MIPS / PQRS a plus

  • Familiarity with Medicare risk adjustment, BPCI, ACO a plus

  • Deep knowledge of advanced analytics tools and languages to analyze large data sets from multiple data sources, with in- depth specialization in some areas. Proficient skills and experience with rational databases, able to code and query data

  • Experience with Big Data such as; Hadoop , Hive, Python, R and SAS /SQL is acceptable as well.

  • Proven ability to effectively syndicate content with business stakeholders and external customers

  • Strong ability to communicate technical concepts and implications to business partners

  • Strong organizational, management and leadership skills

  • Excellent analytical and problem solving skills

    EDUCATION

    The highest level of education desired for candidates in this position is a Master's degree.

    ADDITIONAL JOB INFORMATION

  • This job is office based in either New York City, NY., Hartford, CT., or Wellesley, MA.

    Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

    We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

    Together we will empower people to live healthier lives.

    Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

    We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

    Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

    We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

    Together we will empower people to live healthier lives.

    Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

    We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

    Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

    Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

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