Senior Pharmaceutical Research Analyst

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com

 

 

JOB SUMMARY:

The Senior Research Analyst works to define, develop, process, and analyze reports intended to meet regulatory and market needs. This position is responsible for population measurement, stratification, data analysis and reporting to support corporate initiatives. Using defined national standards, the Sr. Research Analyst creates methods, processes, algorithms, and programming required to produce population identification, stratify populations, and produce data extracts and reports using centralized and regional data sources as required.

 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Develops baseline measurements and populations, and stratifies populations based on defined criteria using centralized and regional as well as internal and external data sources. Supports standardized and ad hoc reporting for utilization and cost reporting.

Reviews data set integrity and creates normative and comparative validation and control criteria and standards for key databases and data sets. Identifies issues related to sources system data inputs and integrity. Implements short and long-term approach to data and/or reporting capability deficiencies. Validates and verifies accuracy of reports and other outputs.

Develops standards and processes for analyzing data to identify clinical issues that may represent opportunities for improvement.

Defines and develops methods for baseline measurements and works with staff to establish quantitative baseline goals. Develops measurement methods to assess initiative results and isolates the impact of interventions versus other variables. Compares goals to actual results and identifies reasons for variance.

Documents data collection, manipulation methods, measures, results, data sources and other information needed for NCQA or regulatory agencies.

Acts as a member of national teams to define, continually review, and refine national standards in support of various initiatives for population identification and stratification, and data presentation and reporting.

Monitors changes in industry standards for clinical analysis and integrates into Health Net processes.
REQUIREMENTS


EDUCATION/EXPERIENCE/MINIMUM REQUIREMENTS:

 

Education:

Bachelor’s degree in Health Economics, Mathematics, Information Systems, or related field

 

Experience:

Minimum six years healthcare experience or related experience in healthcare, finance,economics, or statistics

Experience developing and presenting reports and presentations to Medical Director, Executive and Sr. VP Level audiences required

Demonstrated experience in applied statistics, population-based measurement, and DSM vendor program measurement

 

Knowledge, Skills & Abilities:

Knowledge of HEDIS, NCQA, and other regulatory/industry reporting standards and methodologies is desired

Advanced skills using Microsoft Excel, Access, Word and analytic software.

Must possess working knowledge of SAS, SAS programming, or RQL databases such as SQL Server or Oracle with a focus in generating statistics, populations, and reporting, and have experience in applied programming in SAS, SQL or equivalent.

Requires thorough understanding of major health care systems (claims, pharmacy, authorizations, membership) and issues; medical terminology; and managed care.

Ability to work collaboratively within a team environment and with internal and external customer groups, and act as team lead for specific assigned projects and responsibility areas.

Demonstrated ability to manage multiple projects with minimal supervision and exceptional attention to detail.



 





Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.

 

Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.