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. Leads or participates, with some direction, in projects requiring data solutions, and provides programming and data expertise for simple and moderately complex projects and ad-hoc requests. Presents data and solutions logically to internal and/or external customers. Provides data support and analysis for programs supporting more than 4 million BCBSM beneficiaries, using administrative claims and supplemental data. Supports corporate departments and major initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS, and NCQA/HEDIS. Standardizes, harmonizes, cleans, and shares data with internal and external customers; creates and maintains data-centric product solutions, including third-party program integrations such as HEDIS, risk scores, and PGIP incentives. Supports reporting activities and works to make them more efficient and easier for customers to use. Completes assigned ad-hoc data and analytic requests and works with IT and Clinical Data Strategy to maintain and enhance EMR Clinical Data in the Informatics environment.

Requirements

Bachelor’s degree in Computer Science, Information Systems, Business, Mathematics, Healthcare Information Technology, or a similar field.
Minimum 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 datamarts/data warehouses, OLAP, ROLAP, and data models such as star and snowflake schemas.
Ability to recognize data patterns, quantify potential issues, and identify solutions.
Ability to standardize, harmonize, clean, prepare, and use data to develop 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.
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 performing 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 reporting and insights.

Responsibilities

Lead or participate, with some direction, in projects requiring 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.
Support corporate departments and initiatives including EMR Connectivity, PGIP, Risk Adjustment, STARS, and NCQA/HEDIS.
Standardize, harmonize, clean, and share data with internal and 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 improve their efficiency and usability for customers.
Complete assigned ad-hoc data and analytic requests.
Work with IT and Clinical Data Strategy to maintain and enhance EMR Clinical Data in the Informatics environment.