Director, Health Trends & Analytics

Job Title: Director, Health Trends & Analytics

Labor Grade:

Department: Health Fund

Reports To: Director, Health Fund

FLSA Status: Exempt, Management

About Us:

The 32BJ Health Fund is a multiemployer labor-management fund that provides health benefits to members of SEIU Local 32BJ and their dependents. The Fund has approximately 200,000+ covered lives across 11 states. The Fund is self-insured and is responsible for efficiently managing its resources. The Fund offers comprehensive coverage that includes benefits for medical, hospital, prescription drug, vision, dental, short- and long-term disability and life insurance.

To ensure that the Fund can deliver cost-effective high-quality care, the Fund has embraced value-based plan design and innovative purchasing strategies that encourage plan participants to use high quality primary care and other cost-effective benefits and providers. The Fund dedicates significant resources to actively managing its plans and provider networks to operationalize this strategy. The Fund also invests in innovative policy solutions that will lower healthcare costs for the Fund and its plan participants.

For 2023 and beyond, 32BJ Health Fund will continue to drive innovation, equity, and technology insights to further help the lives of our hard-working members and their families. We use cutting edge technology such as: M365, Dynamics 365 CRM, Dynamics 365 F&O, Azure, AWS, SQL, Snowflake, QlikView, and more. Through this technology investment, we have gathered and analyzed thousands of data insights to influence health insurance legislation and propose new health policy. Our efforts have galvanized many leaders, and the consensus is there is plenty more work to be done.

Please take a moment to watch our video to learn more about our culture and contributions to our members: youtu.be/hYNdMGLn19A

To learn more about the 32BJ Health Fund initiatives, please visit: 32BJ Health Fund Insights

Position Summary:

Reporting to the 32BJ Health Fund Director, the Director, Health Trends & Analytics is essential to our mission of delivering high-quality, cost-effective healthcare. This individual sets the direction and overall analytics strategy that is focused on supporting the goals and the mission of the 32BJ Health Fund to provide best comprehensive health benefits to over 200,000 32BJ SEIU Union members and their dependents. The team focuses on leveraging over 10 years of medical claims data, provider data and pricing data (internal and external) to inform improvements to the plan design, member navigation, direct contracting, and price transparency. The 32BJ Health Fund is at the forefront of leveraging data towards healthcare transformation and this role requires a strong and collaborative leader who is not content with the status quo, able to inspire, and who looks to form long-lasting internal and external partnerships. This is a person who not only has the ability to answer key questions through analytics, but someone who begins by asking key questions. This is an ideal opportunity for an accomplished professional with a detailed understanding of healthcare claims and predictive analytics, who is self-driven, strategic thinker, skilled at navigating and balancing internal business systems with mission-based priorities, and constantly seeking to answer impactful questions with data.

Essential Duties and Responsibilities

• Leadership & Team Management:
  • Expand, lead, and oversee the analytics function within the Health Fund, establishing best practices for using data to drive actionable insights.
  • Foster a collaborative and high-performance team environment.
  • Empower team leaders to effectively solve bottlenecks and challenges within the team.
• Health Analytics & Claims Data Expertise:
  • Utilize deep expertise in health claims data, analyzing trends at the transaction level to identify areas for improvement in cost, utilization, and member experience.
  • Lead quantitative research, analysis and synthesis of key insights across different data sources to deliver actionable recommendations in support to improve healthcare delivery to members.
  • Apply advanced analytics approaches to deepen the understanding of treatment landscapes, patient journeys, and health conditions.
  • Drive prospective review of claims data to provide actionable insights to the Health Fund
• Healthcare System Insight: Apply a robust understanding of the U.S. healthcare system to contextualize data insights and align analytics strategies with broader healthcare trends.
• Benchmarking & Health Trends Analysis:
  • Implement benchmarking strategies and analyze key drivers of healthcare trends, providing recommendations to control costs while maintaining or improving quality.
  • Develop viable predictive analytics models to forecast health trends, identify opportunities, and drive strategic decision-making across the organization.
• Strategic Initiatives:
  • Understand and align initiatives based on the organization's long-term vision.
  • Assist the Health Fund Director in developing and executing strategic plans.
  • Identify opportunities for process improvement and implement innovative solutions.
• Communication: Effectively communicate with all levels of the organization in both verbal and written forms.
• Relationship Building & Cross-Functional Stakeholder Influence:
  • Build partnerships and influence with stakeholders at all levels to drive data-informed decision-making.
  • Work collaboratively with Engineering and Product to enhance platform capabilities, data integration and standardization.
  • Partner with the IT organization to avoid duplication of effort and ensure effective utilization of all analytical resources.
• Innovation: Apply data science methodologies, and where appropriate, machine learning and AI, to advance our analytical capabilities and generate strategic insights.
• Data-Driven Decision Making: Provide the Health Fund Director and leadership team with analytics and reporting that support proactive decision-making and continuous improvement in member services.
• Continuous Improvement: Continuously monitor healthcare and operational metrics to improve member care, optimize benefits, and support innovative solutions.
• Intellectual Ability & Critical Thinking: Act as a big-picture thinker who can align analytics with long-term business goals while solving immediate operational challenges.
• Emotional Intelligence & Social Awareness: Able to identify appropriate behavior based on cultural norms, model the behavior, and support employees in doing the same. Works to ensure that all organizational stakeholders are treated with respect and courtesy.
• Professional Development: Encourages growth and development within their team and the Health Fund as a whole. Constantly looking to learn and grow as an individual as well.

Qualifications & Core Competencies

• Bachelor's degree in a relevant field (e.g., Data Science, Statistics, Public Health, or Biostatistics); Master's degree or Ph.D. is preferred.
• Minimum of 10-15 years of hands-on experience in health analytics, biostatistics, quantitative research, or predictive analytics within the healthcare claims industry required.
• Proven leadership experience in building and leading a health analytics function within a multi-faceted organization.
• Strong knowledge in value-based care models, population health management, and regulatory requirements in healthcare analytics.
• Strategic thinker with a track record of driving data-driven decision making.
• Ability to assist organizational change initiatives, including developing change strategies, engaging stakeholders, and ensuring successful adoption of new processes/systems.
• Extensive experience with data science tools and techniques, with knowledge of when to apply advanced tools like machine learning and AI.
• Mastery of claims data at a granular level, including transactional insights.
• Proficiency in analytical software and data visualization tools (e.g., SQL, R, Python, Tableau, or similar).
• Ability to influence all levels of the organization and to engage across a broad range of business partners and functions both internal and external.
• Strong collaboration skills and high emotional intelligence; able to build relationships and influence across departments and organizational structures.
• Proven ability to drive results through cross-functional teamwork.
• Intellectual curiosity and a passion to learn new things.
• Ability to expand managerial responsibilities, including developing and leading a team.

Why Join 32BJ Health Fund?

This is an exciting opportunity to join a passionate and driven team dedicated to supporting the healthcare needs of 32BJ members. We offer a collaborative environment in which you will work alongside bright and committed professionals in a mission-driven organization that values quality, innovation, and service excellence.