Research Consultant, Clinical Economics
Location: Louisville, Kentucky
Description: Humana is currently seeking to employ Research Consultant, Clinical Economics right now, this position will be assigned in Kentucky. Further informations about this position opportunity please read the description below. Our Search: Research Consultant, Clinical Economics
Our search is focused on identifying a talented research executive to develop and expand ! our clinical economics capabilities. This strategic resource will lead health services research in the areas of health outcomes, cost, quality, etc., and apply key learnings to improve the value of clinical management initiatives within Humana’s Medicare Advantage and Dual Eligible business segments, and other populations of interest.
Deliverables include:
1) Develop actionable (modifiable) condition-level analytics to guide clinical management strategies/tactics and measure results
2) Gather, interpret, and present credible data to support advocacy initiatives on entitlement reform and private plan value
3) Compare and contrast utilization of Medicare Advantage versus Fee For Service options, generating interpretive and actionable data. Sample areas of interest include the following:
- Avoidable hospital admits and re-admits (including methodology and approach to definitions of avoidability)
- Use of Ambulatory! Care Sensitive Conditions (e.g., conservative options vs. agg! ressive surgery) and specific modifiable factors influencing such decisions
- Doctor visits and use of preventative services that causally reduce complications
- Post-discharge physician care â€" analysis of variations
- Develop comprehensive knowledge of Humana’s Medicare segment strategy, capabilities, best practices and tools and the current state (deployment) of the Integrated Care Strategy and how Health and Well-being services create value for Humana’s Medicare customers, consumers and key stakeholders
- Develop and apply keen insight regarding the current Medicare health care regulatory environment and industry competition, and how the components of Humana's business model (i.e. strategy, finances, and operations) interrelate to make Humana competitive in the marketplace
- Apply data mining, data management and analysis skills to the Medicare clinical program development e! nvironment, supporting the documentation, testing, implementation, validation and utilization of systems used in clinical data management activities
- Review clinical data to ensure consistency, integrity and accuracy; design/implement data collection, review, clarification and reporting systems for clinical programs
- Leverage clinical data and research regarding diagnostics, utilization, pharmaceuticals, medical devices, and other therapies to guide stakeholders' behaviors and choices toward positive health and well-being outcomes
- Use predictive modeling to quantify specific events (e.g., illnesses, injuries, and causes of death) for a given client, for the purposes of prevention or behavior modification; Prescribe measures to counter detected/potential risks, with positive messaging for members to manage and reduce risk factors
- Represent Humana as a progressive thought leader on Health and Well-being initiatives for Medicare beneficiaries,! and our commitment to improve the health care system via the Integrate! d Care Model
Our Ideal Candidate
This role requires an inquisitive and analytic leader who is immersed in the science of clinical economics, and driven by the need to effectively measure, interpret and apply quantitative/qualitative research methodologies to “real world†health care decisions.
Enthusiasm and passion for improving healthy behaviors and health outcomes is fundamental to the role, as the ability to communicate this passion in consultative, opportunistic ways to Humana stakeholders.
The successful candidate will be recognized as dedicated research leader, with a strong investigative aptitude complimented by broad and progressive experience in measuring clinical outcomes.
Requirements:
Experience in health services research, including the design and execution of studies that compare medical cost, utilization, quality, access to care, and outcomes across populations
Pub! lished research studies in peer reviewed journals
Proficiency in SAS or related data analysis tools
Experience with using and interpreting clinical information in statistical analyses, such as disease progression and intervention effectiveness, and familiarity with current research using these techniques
Experience with Medicare, Medicaid and “dual-eligible†populations is highly desired
Clinical patient experience (e.g., MD, RN, LVN, pharmacist) would be advantageous to this role
References who will speak to the candidate’s contributions, their passions and commitments to applied research and their capacity for analytical thinking
Advanced or dual degrees in Statistics, Predictive Analytics, Econometrics or related field
Excellent written and verbal communication skills
Schedule
:
Full-time
Primary Location
:
US-KY-Louisville
Role
:
Actuarial
Work Environment Type
:
Of! fice
- .
If you were eligible to this position, please send us your resume, with salary requirements and a resume to Humana.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position starts available on: Wed, 27 Mar 2013 21:21:09 GMT
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