JOB SUMMARY
This job promotes the understanding, integration, and use of healthcare data and information technology in support of scholarly research and addressing healthcare business challenges. Leveraging experience in and knowledge of clinical, technology, and data subject areas, the informaticist will play a crucial role in the design and development of fit-for-purpose research databases (or data sets) and analytic solutions. Their expertise in informatics will be used to tackle research questions of clinical and financial significance to the business, its customers, and the population at large. Serve as a liaison between physicians and research staff to translate data needs and assist in interpretation of analytic findings.
ESSENTIAL RESPONSIBILITIES
- Combine knowledge of healthcare and experience in clinical settings to deliver value and insights through enterprise-grade data & analytic solutions.
- Provide subject matter expertise related to the use of clinical ontologies, vocabularies and code sets in support of internally- and externally-sourced data. Includes support for bi-directional interoperability efforts across the enterprise.
- In coordination with Enterprise Data Governance, assist with the development of business rules and associated code-based definitions related to clinical data domains. Includes but is not limited to sensitive data classification, disease states, clinical episodes, reimbursement episodes, pharamacy use, and care plans.
- Work with teams across health plan, clinical, administrative, and IT business units to understand clinical data needs, evaluate opportunities to fullfill those needs through data and analytics, and participate in the build and delivery of analytic solutions.
- Assist with design, build and deployment of robust analytic data solutions including but not limited to real-time/streaming analytics and alerting, data integration and interoperability, NLP, and AI/ML algorithms. Includes processes to convert prototypes into production solutions.
- Provide clinical process and system expertise and training.
- Other duties as assigned or requested.
EDUCATION
Required
- Bachelor's Degree in Nursing, Informatics, Health Information Management, Information Systems or related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
Preferred
- Master's Degree in Nursing, Informatics, Health Information Management, Information Systems or related field
EXPERIENCE
Required
- 5 years of working in a Clinical Care setting - e.g., ambulatory, hospital, post-acute
- 3 years of hands-on experience with Electronic Health Record (EHR) system like EPIC, Cerner, Allscripts, or comparable
Preferred
- 3 years in Clinical Workflow, Clinical Systems, and the underlying data used to support clinical decision-making
- 3 years in Data Analysis, Analytics, Business Intelligence or Reporting
- 1+ years of working with healthcare claims data
- Experience supporting academic or scholarly research, including preparation of manuscripts and associated data documentation and reporting standards
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- Clinical licensure (e.g., nursing) OR
- Clinical coding certification
SKILLS
- Analytically strong and familiar with clinical informatics concepts, practices, and procedures
- Experience with healthcare vocabularies and code sets including ICD-10, CPT/HCPCS, SNOMED-CT, LOINC, and RxNorm
- Familiarity with healthcare interoperability concepts including HL7 v2.x, FHIR, IHE, X12
- Strong communication skills
Preferred
- Intermediate to advanced SQL coding skills
- Familiarity with R/R Studio with basic R coding skills
- Proficiency in data cleaning, preparation, and transformation (e.g., restructuring) for analytic and research purposes
Language (Other than English):
None
Travel Requirement:
None
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Never
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$86,400.00Pay Range Maximum:
$138,600.00Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at [email protected]
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Skills Required
- Bachelor's degree in Nursing, Informatics, Health Information Management, Information Systems, or related field (or equivalent experience)
- 5 years working in a clinical care setting (ambulatory, hospital, post-acute)
- 3 years hands-on experience with Electronic Health Record systems (Epic, Cerner, Allscripts, or comparable)
- Strong analytical skills and familiarity with clinical informatics concepts, practices, and procedures
- Experience with healthcare vocabularies and code sets (ICD-10, CPT/HCPCS, SNOMED-CT, LOINC, RxNorm)
- Familiarity with healthcare interoperability standards and concepts (HL7 v2.x, FHIR, IHE, X12)
- Master's degree in Nursing, Informatics, Health Information Management, Information Systems, or related field
- 3 years experience in clinical workflow, clinical systems, and underlying clinical data
- 3 years in data analysis, analytics, business intelligence, or reporting
- 1+ years working with healthcare claims data
- Experience supporting academic or scholarly research, including manuscript preparation and data documentation
- Clinical licensure (e.g., nursing) or clinical coding certification
- Intermediate to advanced SQL coding skills
- Familiarity with R / RStudio and basic R coding skills
- Proficiency in data cleaning, preparation, and transformation for analytic and research purposes
Highmark Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Highmark Health and has not been reviewed or approved by Highmark Health.
-
Healthcare Strength — Medical, prescription, dental, and vision coverage are emphasized alongside 100% coverage for preventive exams, with onsite pharmacy access and fitness center availability at major campuses.
-
Retirement Support — An employer‑sponsored 401(k) with a company match is highlighted, with AHN materials illustrating a 100% match on the first 4% plus an additional 1% employer contribution as an example within the enterprise.
-
Wellbeing & Lifestyle Benefits — Wellness programs include stress‑management classes, health coaching, incentives for healthy activities, team‑member discounts, and volunteer incentives, with paid volunteer time also noted in the overall package.
Highmark Health Insights
What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions. We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
