RN Analyst II - Key State Accounts

<p><strong>With more than 8,000 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. Interested in joining us?</strong></p>

Detroit, 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.&nbsp; http://www.bcbsm.com

keywords: medical,presentation,consulting,support,solutions,design,analysis,degree,knowledge,performance,experience,communication

RN Analyst II

Competitive Total Compensation Package

Overview: The senior medical analyst provides medical policy analysis and clinical expertise to the department&rsquo;s account managers and group customers including: Research and consult with subject matter experts on medical policy and utilization inquiries. Represent the department in corporate workgroups including CARIT, JUMP, BCR and Medical Affairs meetings. Monitor changes to covered preventive services and update preventive services documents for the State&rsquo;s active and retiree membership population. Attend statewide retiree meetings to present information on value-added services offered by Blue Cross including Case Management and Online Wellness (WebMD). Educate members on preventive care, skilled nursing and private duty nursing. The ideal candidate is a customer-focused, self-starter who will engage well with group customers and educate members on a variety of health topics.
Responsibilities: <ul> <li>Advise the customers of our updates to the medical policy and how the updates will benefit the members and impact the group&rsquo;s experience and utilization.</li> <li>Assist specific area(s) in: deployment and operational activities and/or development, implementation, and maintenance of clinical operational processes.&nbsp;</li> <li>Identify and/or analyze business problems and devise procedures for solutions to problems; prepare reports and/or analyze, documenting results.&nbsp;</li> <li>Design, develop, modify, test, implement and maintain assigned systems, either independently or as part of a team. Troubleshoot problems and submit recommendations. &nbsp;</li> <li>May be required to interface with other areas, both internal and external, to resolve problems.&nbsp;</li> <li>Assist personnel (both external and internal) by answering questions, supplying information and training.</li> </ul>
Requirements: <div id="requisitionDescriptionInterface.ID1558.row1" class="contentlinepanel" title=""> <ul> <li>Associate's Degree in Nursing or RN Diploma required. Bachelor's Degree preferred.</li> <li>Two (2) to four (4) years of clinical experience.</li> <li>Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.</li> <li>Excellent written and verbal communication skills.</li> <li>Working knowledge of PC applications.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <p>&nbsp;<em>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.</em></p> </div>