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Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary:Apply cutting edge advanced analytical techniques to solve complex problems within the healthcare payer world. Become familiar with the Big Data technology at Horizon BCBSNJ; collaborate with analytical departments including HCM&T. Communicate analytical stories to the risk adjustment revenue analytic community on key findings and engage with key business leaders to promote unique and effective ways of modeling and solving complex problems. Engage with senior leadership to embark on current and critical analytical projects including contracting, network, provider, member, group, special service vendors, and major risk delegation analyses. Utilize available software packages (SAS, Python, R, Big Decisions) and associated libraries to apply complex modeling techniques to solve complex problems. Work closely with our Cognizant Data Science support team & internal staff to execute Risk Adjustment strategy. Oversees the delivery of information from the Impact analysis and Impact Pro Software where applicable to their area(s). Create sustainable and transparent models and analysis for the Risk Adjustment department. Establishes and runs the risk adjustment revenue analytics program management office and provides project management services for projects that meet established governance thresholds. Runs demand management, planning, and prioritization process. Create new sustainable and transparent models and analyses for the organization Build end-to-end data science solutions which will improve healthcare outcomes Collaborate with key business leaders to understand their business problems and come up with analytical solutions. Collaborate with the analytical teams including, Actuarial Services, Finance, IT, Operations, HCM&T to build end-to-end cloud based machine learning production pipelines. Develop scalable and efficient modeling algorithms that can work in production systems. Mentor junior data scientists and provide technical guidance to the team Build customer segmentation models to better understand our customers, and tailor the clinical outcome and healthcare care experience. Education/Experience: Bachelor's Degree in Mathematics, Statistics, Computer Science, Engineering preferred or equivalent work experience. Requires a minimum of 12 years of technical experience in managed care setting. Experience with data visualization and presentation, turning complex analysis into insight. Experience in setting experimental analytics frameworks or strategies for complex scenarios. Experience with manipulating and analyzing complex, high-volume, high-dimensionality and unstructured data from varying sources. Demonstrable track record dealing well with ambiguity, prioritizing needs, and delivering results in a high paced environment. Knowledge: Requires strong knowledge of advanced analytical software packages such as SAS, Cognos, R, SPSS, etc. Knowledge of SQL Server - SSIS, SSRS, Sharepoint, EDI SME- Encounters, Claims, Risk Adj Domain - HealthCare - Medicaid & Medicare Requires extensive knowledge of the healthcare and managed care industry and knowledge of healthcare data. Requires strong knowledge of basic analytical software packages. Requires ability to perform advanced level of research, data analysis and problem solving. Requires excellent analytical thinking skills. Requires strong project management skills Requires strong written and oral communication skills and ability to present complex data analytics clearly. For Shared Services, requires knowledge of big data platforms and software packages such as Aster, Hadoop, Python, Hive, Pig, etc. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.