Medical Informatics Analyst – Business Analyst Advanced

Blue Cross Blue Shield of Michigan•Detroit, MI

About The Position

Provides technical, data, and analytical support to customer departments, including Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment, and HCV. Supports data programs serving more than 4 million BCBSM beneficiaries using administrative claims and supplemental data. Works on data-solution projects, creates and maintains data-centric products and third-party program integrations, supports reporting and ad-hoc analyses, and works with IT and Clinical Data Strategy to maintain and enhance EMR clinical data in the Informatics environment. The role also standardizes, harmonizes, cleans, and shares data, and presents data and solutions to internal and external customers.

Requirements

Bachelor’s degree in Computer Science, Information Systems, Business, Mathematics, Healthcare Information Technology, or a similar field.
Minimum of 4 years of experience.
Ability to use advanced functions in SQL, SAS, or SPSS programming.
Solid working knowledge of Microsoft tools and software, including Excel, Visio, Access, and PowerPoint.
Competency in programming concepts such as Visual Basic, Business Objects, .Net, MDX, C++, or COBOL.
Ability to help others think critically and communicate complex technical solutions to non-technical audiences, orally and in writing.
Ability to translate non-data customers’ thoughts and ideas into data-centric solutions.
Knowledge of data warehousing and data mining concepts, including ETL, datamart design, fact and dimension tables, data views within data marts or warehouses, OLAP, ROLAP, and data models such as star and snowflake schemas.
Ability to recognize data patterns, quantify potential issues, identify solutions, and standardize, harmonize, clean, prepare, and use data for datasets, reporting, and analysis.
Knowledge of healthcare terminology, plan and benefit design, fundamental operational principles, and administrative claims data, including standard coding schemes such as ICD-9/10 and HCPCS.

Nice To Haves

Master’s degree preferred.
Basic understanding of epidemiologic principles and population health management concepts.
Experience working with EMR/EHR clinical data, including encounters, diagnoses, procedures, medications, labs, vitals, immunizations, and clinical documents.
Strong analytical skills and experience using Databricks, SQL, and data analysis tools to investigate, validate, and reconcile large clinical datasets.
Experience with EMR platforms and CCDA data, such as Epic, Oracle Health/Cerner, athenahealth, or eClinicalWorks.
Knowledge of C-CDA documents, including clinical data extraction, mapping, transformation, validation, and downstream processing.
Experience developing and maintaining data mappings and conducting data quality, reconciliation, and root cause analysis for clinical data integrations.
Ability to independently execute EMR operational activities, including project planning, status tracking, issue resolution, stakeholder communication, and process improvement initiatives.
Experience collaborating with business and clinical stakeholders to identify opportunities for new HEDIS measures, quality programs, and clinical data acquisition efforts.
Familiarity with cloud-based data platforms and healthcare interoperability standards such as HL7, CCDA, and FHIR, and ability to analyze EMR/ADT data and develop meaningful reporting and insights.

Responsibilities

Lead or participate, with some direction, in projects that require data solutions.
Provide programming and data expertise for simple and moderately complex projects and ad-hoc requests.
Present data and solutions logically to internal and/or external customers.
Provide data support and analysis for programs supporting more than 4 million BCBSM beneficiaries, using administrative claims and supplemental data.
Provide analysis and data support to corporate departments, including Quality, Risk Adjustment, Value Partnership, Care Management, and Hospital Contracting, for initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS, and NCQA/HEDIS.
Standardize, harmonize, clean, and share data within the organization and with external customers.
Create and maintain data-centric product solutions, including third-party program integrations such as HEDIS, risk scores, and PGIP incentives.
Support reporting activities and continuously improve their efficiency and ease of use for customers.
Complete assigned ad-hoc data and analytics requests.
Work with IT and Clinical Data Strategy to maintain and enhance EMR clinical data in the Informatics environment.