Senior Health Care Analyst / HCV Business Analytic Services

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.

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Competitive Compensation and Benefits Package

Overview: <span style="font-family: arial; font-size: small;">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.<br /><strong><br />Departmental Preferences<br /></strong><br />Independently leads health research projects by performing conceptualization, design, execution, and interpretation of novel healthcare initiatives. Partners with staff to provide well-defined, accurate, and timely analyses that answer client questions; drives the completion of these analyses through project management of other HCV A&amp;I staff, monitors existing programs, and leverages evidence-based analyses to guide decision making across various health insurance products. Provides leadership that yields quantitative collaborations to enhance health care value.<br /></span>
Responsibilities: <ul> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Leads in the research, analysis, identification, and evaluation of data from assigned problems to evaluate existing and potential trends and issues.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Possess and maintain extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Develop lines of communication to discuss/review the results of the 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.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand for change management and initiate actions needed to plan, organize and control team activities.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Independently develop and plan, reports, papers and/or other materials in a clear and concise manner.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Provide expertise and guidance to the unit and corporate staff as required.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Acts as liaison between corporate business areas and participates in group or committee discussions.</span></span></div> </li> <li> <div><span style="font-family: arial;"><span style="font-size: small;">Other duties may be assigned.</span></span></div> </li> </ul>
Requirements: <div id="requisitionDescriptionInterface.ID1502.row1" class="contentlinepanel" title=""> <ul> <li id="requisitionDescriptionInterface.ID1502.row1" class="contentlinepanel">Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is required. Master's Degree in related field preferred.</li> <li class="contentlinepanel">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).</li> <li class="contentlinepanel">Excellent analytical, planning, problem-solving, verbal and written skills to communicate complex ideas.</li> <li class="contentlinepanel">Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).</li> <li class="contentlinepanel">Strong working knowledge of data languages such as SAS or SQL.</li> <li class="contentlinepanel">Ability to work independently, within a team environment and communicate effectively with employees at all levels.</li> <li class="contentlinepanel">Other related skills and/or abilities may be required to perform this job.</li> </ul> </div> <div id="requisitionDescriptionInterface.ID1558.row1" class="contentlinepanel" title=""> <div><strong>Qualifications</strong></div> <ul type="1"> <li>Experience in ICD-10, HCPCS and CPT codes.&nbsp;</li> <li>Experience with medical and pharmacy claims data.</li> <li>Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.</li> </ul> </div>