Sr Mgr- Analytics & Data Science (Cost of Care) - HYBRID

Blue Cross Blue Shield of Arizona•Phoenix, AZ

8d•Hybrid

About The Position

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona. PURPOSE OF THE JOB Manages the day-to-day activities of the Analytics & Data Science department. Serves as the primary contact and resource for staff. Provides oversight, direction, development, problem resolution, and leadership for the Analytics & Data Science team. The team’s responsibilities include: Transforming data into meaningful and actionable information for various customer segments Performing strategic data analysis to support medical management programs, quality and value-based partnerships, and a strategic and predictable corporate provider reimbursement strategy Establishing measurement standards Identifying previously unknown relationships within data to support analyses of trends and healthcare issues

Requirements

Bachelor's degree in business, mathematics, statistics, healthcare administration, or a related field of study (All Levels)
Supervisor: 3 years of experience in data science, data analytics and reporting, or scientific analysis
Supervisor: 1 year of experience in a supervisory or management field and/or project management
Manager: 5 years of experience in data science, data analytics and reporting, or scientific analysis
Manager: 3 years of experience in a supervisory or management role
Senior Manager: 10 years of experience in data science, data analytics and reporting, or scientific analysis
Senior Manager: 7 years of experience in a management role
Intermediate PC proficiency
Intermediate skill in using office equipment, including copiers, fax machines, scanners, and telephones
Basic skill in word-processing and presentation software
Intermediate proficiency in database, spreadsheet, statistical analysis, query and data-mining, and business intelligence software
Advanced project management skills
Advanced mathematics and statistics skills
Working knowledge of classification tools, including ICDs, DRGs, ACGs, and ETGs
Maintain confidentiality and privacy
Communicate professionally with internal and external customers
Analytical skills in observing and documenting processes at a detailed level
Proficiency in process improvement and business process design
Analyze and research data and propose solutions to resolve issues
Ability to use a variety of classification tools and manipulate large quantities of data
Establish, contribute to, and maintain a positive and productive work environment
Ability to plan, organize, and manage the work of assigned personnel
Advanced knowledge of HRIS systems, employment law, and HR regulations
Ability to optimize resources to ensure a cost-effective operation, including proactively planning to move staff from one role to another as staffing needs, business priorities, or workload changes
Ability to build effective teams
Ability to implement new processes and procedures

Nice To Haves

Master's degree in business, mathematics, computer science, or a related field of study (All Levels)
Supervisor: 3 years of experience in a management or leadership role
Supervisor: 1 year of experience in the insurance or healthcare field
Manager: 5 years of experience in a management or leadership role
Manager: 3 years of experience in the insurance or healthcare field
Senior Manager: 10 years of experience in a management or leadership role
Senior Manager: 7 years of experience in the insurance or healthcare field
SAS Certification
Tableau Certification
Associate of the Society of Actuaries (ASA)
Advanced proficiency in database, spreadsheet, statistical analysis, query and data-mining, business intelligence software including SAS, and data visualization tools such as Tableau
Ability to establish and maintain professional relationships with community and professional groups that reflect favorably on the department and BCBSAZ.

Responsibilities

Manage the day-to-day operations of the department.
Administer, interpret, and maintain current working knowledge of BCBSAZ systems, procedures, forms, and manuals related to the assigned area of responsibility.
Review, update, and maintain the accuracy of department documentation, computer files, policies, and procedures related to department goals and objectives.
Keep staff informed of new or updated standards, systems, procedures, forms, and manuals through staff meetings and verbal and written communications.
Direct, evaluate, define, and improve quality, quantity, and timeliness standards to achieve individual and department performance goals as defined within department guidelines.
Provide guidance, motivation, and encouragement to staff.
Conduct performance evaluations, identify and coordinate training needs, and evaluate and make recommendations regarding employment decisions.
Consult and coordinate with internal departments, external Blue Plans, business partners, and government agencies.
Identify and create appropriate technical solutions to address business issues.
Monitor external economic and healthcare issues affecting trends and prepare succinct, easy-to-understand presentations of results and conclusions.
Serve as an internal consultant to help define analytical needs and assist end users with interpreting and applying analytical results.
Explore relevant data sources to determine which metrics can be produced.
Prepare succinct, easy-to-understand presentations of results and conclusions.
Analyze, interpret, and communicate information, and present results in formats that facilitate decisions and actions.
Assist with developing new performance measurement tools and approaches.
Maintain current knowledge of emerging measurement standards.
Evaluate analytical findings to ensure accurate data interpretation and the development of meaningful data-mining results.
Research the latest developments from governmental and national entities, including CMS, NCQA, AHRQ, and Leapfrog, regarding the establishment of metrics used to monitor and/or define provider quality information for the general public.
Present research findings and recommendations in written and verbal formats.
Lead the team in analyzing and mining multiple data sources, selecting statistically valid data samples, and building, testing, and implementing statistical models by investigating appropriate methods and algorithms.
Effectively summarize and present findings to executive leadership to drive business decisions.
Design custom dashboards for various areas of the company.
Research and define key metrics and data sources.
Monitor dashboards for continued effectiveness and improvement opportunities.
Identify and create business tools and analytical solutions to address business issues.
Perform all other duties as assigned.