Advanced Analytics Analyst II

Blue Cross Blue Shield of MassachusettsBoston, MA
2d$77,000 - $96,030

About The Position

Ready to help us transform healthcare? Bring your true colors to blue. The Role Network Performance Improvement data analysts are responsible for providing data and reporting used to measure quality metrics in support of contracting strategies. This includes the development and maintenance of data and reporting programs used to support provider arrangements, including risk contracts such as the Alternative Quality Contract (AQC) and expansion into other products/providers (PPO, Medicare, Small Group and Hospital). Key Accountabilities: Provide expertise in electronic clinical data capture and the development of electronic clinical data reporting and analysis. Development of SAS programs which measure quality metrics used in the measurement & evaluation of providers engaged in incentive programs & other quality based contracts Troubleshoot production reporting issues, identify root causes and implement necessary coding updates Work with complex health care data to develop and produce standard ad hoc reports and analysis including attribution and clinical data collection and reporting Analyzes and investigates Quality data as it relates to Quality measurement and other pertinent data to identify areas of improvement Assists with research, development, monitoring, and reporting of special projects as requested Responsible for developing and documenting project and programming requirements for new and changing quality reporting applications, maintaining proper documentation and back-up for all reporting and data applications

Requirements

  • Proficiency in writing maintainable, supportable, well-documented SAS code
  • Strong quality control ethic, ability to assess accuracy of output at report level as well as investigate potential issues at a granular level.
  • Two plus years of experience programming Quality measures.
  • Strong focus on data manipulation and ability to drive results to completion with minimal supervision.
  • Ability to extract, cleanse, integrate medical and pharmacy claims and membership data from various platforms and sources
  • Creative problem-solving skills with strong verbal and communication skills.
  • Excellent customer focus and ability to work effectively in cross-functional teams
  • 3+ years SAS programming experience required
  • 3+ years’ experience analyzing healthcare claims data
  • Prior experience working with medical and pharmacy claims data at either a health plan, provider group or health data vendor preferred.
  • Development and use of PC applications for data analysis (specifically spreadsheet and database systems (MS Excel, MS Access)
  • Prior experience working with medical and pharmacy data at either a health plan or provider group or health data vendor
  • Strong knowledge of healthcare delivery systems, provider risk and incentive programs
  • BA/BS required. Master preferred.

Responsibilities

  • Provide expertise in electronic clinical data capture and the development of electronic clinical data reporting and analysis.
  • Development of SAS programs which measure quality metrics used in the measurement & evaluation of providers engaged in incentive programs & other quality based contracts
  • Troubleshoot production reporting issues, identify root causes and implement necessary coding updates
  • Work with complex health care data to develop and produce standard ad hoc reports and analysis including attribution and clinical data collection and reporting
  • Analyzes and investigates Quality data as it relates to Quality measurement and other pertinent data to identify areas of improvement
  • Assists with research, development, monitoring, and reporting of special projects as requested
  • Responsible for developing and documenting project and programming requirements for new and changing quality reporting applications, maintaining proper documentation and back-up for all reporting and data applications

Benefits

  • paid time off
  • medical/dental/vision insurance
  • 401(k)
  • a suite of well-being benefits to eligible employees
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