Sr. Health Care Analyst-Comm Risk Adjustment

Blue Cross Blue Shield of Michigan•Detroit, MI

35d

About The Position

Responsible for planning, organizing, directing, implementation, and leading department assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements. Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues. Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies. Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters. Develop lines of communication to discuss/review results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions. Investigate, review, recommend, communicate and implement solutions which identify problems/root cause of issues. Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities. Independently develop and plan, reports, papers and/or other materials in a clear and concise manner. Provide expertise and guidance to unit and corporate staff as required. Acts as liaison between corporate business areas and participates in group or committee discussions.

Requirements

Minimum 3 years SQL experience required
Data analysis experience
3 years healthcare experience required
Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is required.
Six (6) or more years experience in related experience, typically in two (2) subject areas (e.g. financial analysis, planning, health care economics, health care policy, statistical modeling, business decisions, analysis, or business management).
Excellent analytical, planning, problem solving, verbal and written skills to communicate complex ideas.
Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
Strong working knowledge of data languages such as SAS or SQL.
Ability to work independently, within a team environment and communicate effectively with employees at all levels.

Nice To Haves

Minimum 1 year python experience preferred
1 year Databricks preferred
Risk Adjustment experience preferred
Master's Degree in related field preferred.
Other related skills and/or abilities may be required to perform this job.

Responsibilities

planning
organizing
directing
implementation
leading department assignments
Research, compile and analyze appropriate and relevant data
make recommendations for operational improvements
Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues
Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters
Develop lines of communication to discuss/review results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions
Investigate, review, recommend, communicate and implement solutions which identify problems/root cause of issues
Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities
Independently develop and plan, reports, papers and/or other materials in a clear and concise manner
Provide expertise and guidance to unit and corporate staff as required
Acts as liaison between corporate business areas and participates in group or committee discussions