Data Science Prior Authorization Reporting Lead (DSIS3SPI) – Internal

Data Science Prior Authorization Reporting Lead (DSIS3/SPI) Internal

This opportunity is internal and available to current HCA employees only.

The Data Science Prior Authorization Reporting Lead applies advanced statistical techniques mathematical modeling and specialized programming to extract actionable insights from complex health care data in support of Apple Healths prior authorization program. The position develops data storytelling and analytics to inform policy decisions and improve health care outcomes using tools like Power BI Tableau SQL R and Python. This is a great promotional opportunity for a highly experienced data professional within HCA with a background in public health analytics.

All HCA employees will apply an equity lens to their work which may include but is not limited to all analyses of core business and processes.

About the division:

The DATA (Data Acquisition Transformation and Analytics) team of the Health Care Authority within the Strategy Policy and Innovation (SPI) division is responsible for leading agency data strategy; and leading the implementation maintenance and enhancement of the data management analytics and reporting systems that inform agency leadership in support of HCAs goals as well as for monitoring program performance to ensure accountability and alignment with agency activities..

About the position:

This position utilizes data informatics mathematics statistics and specialized programming to extract knowledge from structured and unstructured health care data. As a highly experienced Data Scientist the positions focus is on creating advanced data analytics applying statistical techniques and developing data storytelling in support of Apple Health (Medicaid) prior authorization program and to report out on trends insights and critical funding and policy inquires. This position will provide expert guidance for developing actionable insights that can be used to improve health care outcomes solve problems meet reporting requirements and make informed policy decisions.

This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions both on-site and telework eligible positions is within the State of Washington. This position reports to Olympia WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment regardless of telework status or location.

Some of what you will do:

• Generate high quality data products from structured and unstructured data sources using programming languages such as R SAS SQL M code and/or Python to write data code/query scripts.
• Lead the development of advanced algorithms build data models and automate data processing tasks.
• Develop complex data quality processes and metrics to ensure accurate and timely reporting to Centers for Medicare and Medicaid Services (CMS) and the Washington state legislature.
• Lead multiple complex data science projects in collaboration with internal and external partners.
• Use and oversee the use of tools such as R Power BI and/or Tableau to develop data models and interactive visualizations.
• Ensure overall compliance with agency process and external policy and/or legal requirements while assuring accuracy and completion of analytic projects.
• Determine the best strategy for the delivery of services within the work unit to include but not limited to ensuring a balanced workload distribution between staff.
• Maintain a participatory process by involving staff in decisions affecting them.
• Mentor staff members to build their knowledge and skills as it relates to analytical techniques agency programs data infrastructure processes and best practices.
• Set standards and objectives for performance and identify strategies for implementation.
• Serve as expert of the use of advanced quantitative research methods commonly used in scientific surveillance and/or epidemiological research to analyze and interpret data.
• Oversee and apply statistical analysis techniques to find patterns trends and conclusions.
• Serve as key data science technical expert for the agency within the prior authorization team.
• Provide advice and consultation on agency data policy development and strategic recommendations.
• Review proposal plans and implementation activities for statistical analysis such as regression analysis clustering or time series analysis.
• Mentor journey or entry level data scientists through peer review constructive feedback and knowledge sharing.
• Provide expert consultation on how to manage analytic barriers opportunities and implement innovations.
• Oversee the gathering prioritizing and validation of data requirements.
• Provide consultation to agency leadership regarding data access feasibility statistical validity etc.
• Determine resolution of complex issues using innovated methods to solve complex technical challenges.
• Develop innovative and effective approaches to solve requestors analytics problems.
• Assess statistical approaches tools and methods for feasibility relevancy and effectiveness.
• Troubleshoot highly complex issues in a timely fashion and minimizes disruption of data transmission.
• Inform complex data definitions and logic models for analysis and measures.
• Oversee staff data validity checks to identify and report anomalies in the data.
• Propose and lead technical solutions informed by health care systems knowledge.

Required qualifications:

Qualifying candidates will meet one of the following criteria options:

Option 1:

Masters degree or higher in informatics data science mathematics computer science statistics biostatistics epidemiology or related technical or quantitative field and one (1) year of experience performing data science or informatics data work within health care public health and/or behavioral health.

• Experience must include at least one (1) year working with complex analytics data visualization software and R SAS SQL M code and/or Python programming.

Option 2:

Bachelors degree in a field identified above and three (3) years of experience performing data science or informatics data work within health care public health and/or behavioral health.

• Experience must include at least three (3) years working with complex analytics data visualization software and R SAS SQL M code and/or Python programming.

Option 3:

Seven (7) years of experience performing data science or informatics data work within health care public health and/or behavioral health.

• Experience must include at least three (3) years working with complex analytics data visualization software and R SAS SQL M code and/or Python programming.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.
• Strong analytical skills with the ability to collect organize analyze and disseminate significant amounts of information with attention to detail and accuracy.

Preferred qualifications:

• Deep knowledge of medical and/or pharmacy coding such as ICD-10 Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes; health care business and systems including health care prior authorization processes.
• Demonstrated ability to work effectively in a multi-disciplinary team comfortable interacting technically and politically with staff members at all levels of the agency.
• Demonstrated high level of workload & project management including organization and prioritization of tasks.
• Excellent technical written and verbal communication skills and visual story-telling through dashboards reports and data visualizations.
• Highly advanced experience working with large and complex data sets; advanced level SQL R Python SAS or other programming skills; significant experience with data visualization using Power BI Tableau and other similar visualization tools.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position you will need to complete your profile which includes three professional references and attach in separate files:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume

To take advantage of veteran preference please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy) NGB 22 or USDVA signed verification of service letter.
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in .

About HCA:
Functioning as both the states largest health care purchaser and its behavioral health authority the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars HCA purchases health care including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention crisis and recovery supports to all Washington residents.

What we have to offer:

• Meaningful work with friendly co-workers who care about those we serveVoices of HCA
• A clear agency mission that drives our work and is person-centeredHCAs Mission Vision & Values
• A healthy work/life balance including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit packageWA State Government Benefits
• A safe pleasant workplace in a convenient location with restaurants and shopping nearby.
• And free parking!

Notes:

Prior to a new hire a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected included and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary employee-led groups whose aim is to foster a diverse inclusive workplace aligned with HCAs mission.Our diversity and inclusion efforts include embracing different cultures backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women racial and ethnic minorities and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age disabled and Vietnam era veterans as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them please contact us at .Persons with disabilities needing assistance in the application process or those needing this job announcement in an alternative format may contact Lisa Fleming at or

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify is a registered trademark of the U.S. Department of Homeland Security.

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