Senior Decision Support Consultant

Job Summary

This position will utilize technical, analytical and business expertise in the design, development, and support of various projects and data analysis of a complex nature. It advises and consults on Enterprise Informatics strategy, business relationships, the impact of other Highmark business decisions on Informatics, personnel utilization, and technology planning. The incumbent executes all facets of the Informatics project management process, may lead multiple project managers, mentor lower‑level analysts, and utilizes advanced technical skills to prepare and analyze large, complex data sets.

Using knowledge of corporate systems and data sources in Highmark business units, the incumbent develops and analyses data to solve complex issues, understanding terminology, techniques and reimbursement mechanisms in healthcare.

• Provide insight into Enterprise Informatics analyses and offer consultative guidance to Highmark partners.
• Act as a key business contact across multiple business units for issue resolution.
• Maintain and contribute to the shared Enterprise Informatics Intellectual Capital Repository, including content submissions and best practices.
• Lead liaison advocacy for emerging Highmark business areas, prioritizing new work requests against existing workload.
• Provide overall technical direction of complex projects, implement decision support applications, and consult on design, testing, and enhancement of reporting systems.
• Develop and foster relationships across Highmark, professional organizations, user groups, and industry trade groups to stay current with technology and analysis methods.
• Design and implement analytic models and methodologies for profiling providers, assessing patient outcomes, cost and utilization trends, and other decision support activities.
• Lead special complex studies, simulations, statistical testing, and projects addressing unique questions from senior management, business partners, coalitions, or governmental agencies.
• Develop and maintain highly complex computer programs using 4GL programming languages and advanced database/SQL technology, including system testing and documentation.
• Integrate data from external sources such as HC4, HMS, Medco, Acxiom, NCQA, and BCBSA with internal Highmark data.
• Evaluate and select new clinical and technical products and methodologies to enhance current capabilities.
• Research, manipulate, and prepare data related to Health Management programs, documenting activities and results.
• Execute all facets of the Informatics project management process and lead multiple project managers.
• Define problems, gather requirements, design methods, perform statistical testing, and present findings.
• Ensure that resulting methodologies, processes, and software systems are compatible with corporate technology architecture and manage ISG implementation.
• Identify parallel issues and project needs in medical and business literature.
• Other duties as assigned or requested.

• Minimum bachelor's degree or equivalent experience.
• 10–15 years experience supporting a marketing function or data analyst role, or in a business environment applying technology to solve business problems.
• 10–15 years experience querying relational databases using 4GL programming languages such as SAS and SQL.
• 10–15 years experience performing project management activities (problem identification, meeting standards, information collection).

• Strong programming skills with SAS or SQL and other 4GL languages.
• Understanding of relational databases, normalization schema, data source availability, field interpretation, file structures, and system requirements.
• Knowledge of Highmark business areas, processes, data flows, file structures, and system functionalities.
• Advanced analytics skills to solve complex problems and reveal actionable insights.
• Ability to concurrently handle multiple complex tasks while maximizing productivity.
• Strong written and verbal communication skills, including consultative customer service, conflict resolution, and presentations.
• Knowledge of healthcare terminology, techniques, and reimbursement mechanisms.
• Travel: 0–25%.

Minimum: $ – Maximum: $. Base pay is determined by qualifications, experience, and contributions.

Employees may have access to confidential customer information and must comply with HIPAA and all company privacy and security policies. All employees must also adhere to the code of business conduct and applicable laws and regulations.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on veteran status, disability, or any protected category under applicable law.

Office-based. Teaches/trains others regularly.