Sr. Analyst Healthcare Claims

<p>With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.</p>

Grand Rapids, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

keywords: analysis,network,analysis,process management,performance,management,training,experience,knowledge,organization,degree,teamwork,solutions,implementation,communication,analysis,department preference,department requirements

Full-time

Competitive Total Compensation Package

Overview: Blue Care Network of Michigan is seeking a Senior Claims Process Improvement (CPI) Analyst responsible for effectively improving process opportunities within Claims Operations. The primary purpose of the CPI Analyst is to analyze and make decisions regarding current processes, as well as develop, propose and implement new processes within the Claims Division.
Responsibilities: <ul> <li>Essential duties and responsibilities include:</li> <li>Act as primary tester for system changes and improvements.</li> <li>Develop and implement necessary changes to processes and procedures to correct/improve output performance.</li> <li>Work cooperatively with the Training Team to update procedures as a result of process improvement initiatives.</li> <li>Identify process improvement opportunities.</li> <li>Develop methodologies for measuring process defects.</li> <li>Act as a change agent by challenging existing approaches to performance.</li> <li>Performs other reasonably related duties, including special projects as assigned by immediate supervisor and other management staff as required.</li> </ul>
Requirements: <ul> <li><strong>Must have Analyst experience, preferably in the healthcare claims environment.</strong></li> <li>Bachelor's degree required with major in business or health care related field with coursework in math/statistics/process improvement/project management preferred.</li> <li>Or, an Associate&rsquo;s Degree or two years college credits required with a major in business improvement/project management preferred and one (1) year proven process improvement experience in addition to the experience required below.</li> <li>One (1) year operational experience in process improvement role, with proven success required including:</li> <li>Experience organizing and analyzing improvement opportunities</li> <li>Experience in documentation of issues, processes, workflows, etc.</li> <li>Experience in project management</li> <li>Experience with a quality management program preferred</li> <li>Excellent verbal and written communication skills including the ability to conduct presentations required.</li> <li>Excellent interpersonal skills including the ability to interact with team members, internal and external customers and all levels of the organization required.</li> <li>Excellent problem solving skills including the ability to identify and implement necessary steps to achieve process improvement required.</li> <li>Excellent analytical skills including the ability to evaluate measure and map current processes and recommend/implement changes required.</li> <li>Excellent organizational skills with the ability to handle multiple projects and timeliness required.</li> <li>Intermediate knowledge of Microsoft Word and Excel required.</li> <li>Basic knowledge of Microsoft Access required.</li> </ul> <strong>DEPARTMENT REQUIREMENTS</strong><br /> <ul> <li>Experience working with healthcare claims</li> <li>One (1) year of Analyst experience required with proven experience in problem analysis, data analysis, root cause identification, document and problem resolution activities.</li> <li>Ability to develop creative solutions to business issues.</li> <li>Highly organized, self-starter with proven ability to produce high quality output.</li> <li>Strong organizational skills and follow-through abilities with particular attention to detail required.</li> <li>Ability to work effectively with multiple internal clients and to handle multiple projects and implementation timeframes with minimal supervision.</li> <li>Intermediate knowledge of Microsoft Suite (Word, Excel, PowerPoint and Outlook).</li> <li>Basic knowledge of Microsoft Access and Visio.</li> </ul> <strong>DEPARTMENT PREFERENCE</strong><br /> <ul> <li>Working knowledge of Government Programs preferred.</li> <li>Demonstrated experience working with project implementation preferred</li> </ul> All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.