Sr Analyst

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.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" 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="" 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="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: leadership,quality assurance,compliance,operations,management,department preferences,experience,education,knowledge and skills


Competitive Total Compensation Package

Overview: <span style="font-family: arial;"><span style="font-size: small;"><strong>Leadership responsibility to coordinate the development and implementation of programs and strategies to improve service&nbsp;</strong></span></span><span style="font-family: arial;"><span style="font-size: small;"><strong>to our customers.</strong></span></span>
Responsibilities: <ul><li>Develop and improve work flows and business processes within area(s) to improve customer service, decrease operational costs and improve overall quality.</li><li>Identify and/or analyze business problems and devise procedures for solutions to the problems. Effectively lead projects/teams in order to produce desired results.</li><li>Responsible for corporate communication of project results.</li><li>Recommend and assist with implementing standard policies and procedures for providing routine service.</li><li>Assure that corporate compliance is communicated, implemented and monitored on an ongoing basis.</li><li>Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.</li><li>Assist personnel (both internal and external) by answering questions, supplying information and training.</li><li>Develop and maintain an effective working relationship with customers.</li><li>Other duties may be assigned. </li></ul>
Requirements: <ul> <li>Bachelor's Degree in related field preferred.</li> <li>Four (4) to seven (7) years&rsquo; experience in related field.</li> <li>Supervisory and/or Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.</li> <li>Ability to plan, organize, direct and control projects.</li> <li>Excellent written and verbal communication skills.</li> <li>Ability to lead and contribute to process improvement projects.</li> <li>Working knowledge of PC applications and/or mainframe required.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <p><strong><u>Department Preferences:</u></strong></p> <ul> <li>Working knowledge of ikaSystems Claims &amp; Enrollment Platforms.</li> <li>Working knowledge of PORTICO.</li> <li>Familiarity with CMS claims processing guidelines.</li> <li>Experience with Medicare Advantage claims processing.</li> <li>Familiarity with BCBSM Provider Networks.</li> <li>Familiarity with provider validation sites, i.e., National Plan &amp; Provider Enumeration Systems (NPPES), Department of Licensing and Regulatory Affairs (LARA), Office of Inspector General exclusion list, etc.</li> <li>Excellent communication skills, written and verbal with experience presenting.</li> <li>This position requires a high level of analytical skill and the applicant must be very detail oriented and have ample experience at research.</li> </ul>