EDQ Data Team Lead - Research Scientist 3

This position serves as team lead for the HCA interdivisional data team, providing expert direction, technical guidance, and training/mentoring to analytical staff on divisional and interdivisional data analysis projects related to performance measurement, diagnostic-based risk adjustment, and utilization analysis necessary for management of health care programs., * Directs analytical efforts in support of agency program integrity efforts related to Medicaid, including identifying data anomalies, utilization patterns, or payment discrepancies that may indicate fraud, waste, or abuse, and applying analytical expertise to inform program integrity reviews and corrective actions.

• Leads the data-related efforts underlying Managed Care organization compliance, including directing the analysis, validation, and reporting of encounter data used to monitor and ensure Managed Care organizations’ adherence to state and federal contractual, regulatory, and reporting requirements.
• Leads the analysis of health care data to estimate the need for health care services, evaluate and improve payment methodologies, estimate the impact of changes in delivery and payment systems, and measure health care outcomes. This includes planning and designing research studies, developing methods and procedures for data analysis projects, and developing and managing the databases required to carry out these studies.
• Interprets data and study results to inform management on potential policy and program changes and executes highly technical analyses to support management decisions and strategic planning for program outcomes and cost containment.
• Provides technical direction and consultation to management and staff on the above activities and represents the department on planning teams responsible for the collection and dissemination of related information.

Three (3) years of advanced professional research experience in health or social sciences that demonstrates:

• Statistical analysis software such as SAS and/or SQL
• Data analysis, data qualification, data transformation and interpretation, and modelling, including multiple regression techniques
• Project management, report writing and oral presentation of analysis and research results
• Computer skills sufficient to construct tables and graphs displaying data/results to facilitate data analysis or to visually report data using statistical analyses, database reports and presentation software
• Demonstrated familiarity with health care data such as medical claims, public health data, electronic medical records, disease registries, or vital statistics data.

Preferred Qualifications

• Master’s or doctoral degree in health science, social science, or related discipline
• Experience with:
• Health services research methods or health care policy
• Large data systems stored in complex SQL based data tables in networked warehouse systems
• Health care HIPAA claims data interchange standards, such as ANSI X12 EDI
• Knowledge of Minnesota public health care programs, including coverage policy and purchasing strategies
• Experience in leading staff and teams, training and coaching staff, engaging in process improvement work, performing project management, and managing relationships with customers
• Ability to work effectively with staff at all levels within and outside of the organization, and have excellent verbal and written communication skills
• Our employees are dedicated to ensuring cultural responsiveness. Preferred candidates will have a variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.

REFERENCE/BACKGROUND CHECKS - The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you’ll do is more than just a job.

At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.