Senior Population Health Insight Specialist (Fortify)
About The Position
The Senior Population Health Insight Specialist is adept at bringing together diverse data to predict trends and drive change in pediatric population health. This position is responsible for cost and utilization analysis of pediatric claims, and for integrating this analysis with electronic health record data, geographic data, and other signals in a predictive manner to determine optimal interventions in value-based care contracting, physician outreach, and care management activities. The day-to-day work involves development and maintenance of cost and utilization dashboards, training of others in their effective use, analysis of both prescription and pharmacy fill data, and trend analysis of EHR and health information exchange data to predict future utilization trends, as well as evaluation of the effectiveness of various interventions.
Requirements
- Bachelor’s degree required.
- 4 years relevant experience.
- Experience with cost and utilization analysis of claims data
- Experience working with Electronic Health Record (EHR) data types and large EHR databases
- Demonstrated ability to use statistical modeling to support decision making as a means to improve quality, impact costs or determine financial impact of a proposal.
- Ability to translate detailed and complex data into understandable conclusions and offer valued solutions.
- Must have demonstrated organizational skills, the ability to manage a large volume of work, tight deadlines, and frequently shifting priorities.
- Strong proficiency with SQL and at least one analytics or statistical tool (e.g., Python, R, SAS).
Nice To Haves
- Master’s degree in Statistics, Public Health, Healthcare Administration, or related field from an accredited college or university.
- 3 - 5 years of experience in design, collection, analysis, interpretation and presentation of pediatric population health information
- Deep understanding of and experience with risk adjustment, quality reporting (HEDIS, STAR, ACO measures), and healthcare reimbursement models.
- Proficiency with data visualization platforms such as Power BI, Tableau, or Oracle Cloud Infrastructure
Responsibilities
- Collaborates with data engineering and IT teams to integrate, and maintain population health data sources, including EHR data, claims data, and other external sources.
- Ensures high standards of data accuracy, completeness, and timeliness across multiple systems and platforms.
- Translates complex data into clear insights, recommendations, dashboards, and visualizations that inform executive decision-making.
- Conducts cost, utilization, quality, and outcomes analysis to support value-based contracts, quality improvement, and reimbursement initiatives.
- Develops predictive and risk stratification models to support care management workflows and population health strategies.
- Serve as a subject matter expert for population health analytics, supporting interdisciplinary teams including clinical quality, finance, and informatics
- Supports the design, evaluation, and optimization of programs focused on chronic disease management, preventive care, care coordination, and health equity.
- Analyzes care management workflows and program for quality and process improvement
- Mentors junior analysts and contributes to analytic best practices, documentation, and knowledge sharing.
Benefits
- Medical, Dental, and Vision Insurance
- Paid Time Off
- Long-term and Short-term Disability
- Retirement Savings
- Health Saving Plans
- Flexible Spending Accounts
- Certification and education support
- Generous Paid Time Off
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What This Job Offers
Job Type
Full-time
Career Level
Senior
