Medical Informatics Analyst – Business Analyst Advanced

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 (Hybrid)

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.&nbsp;<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 />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 />For Application Timeline &amp; Selection Process:&nbsp;<a href="https://s3.amazonaws.com/data.vizirecruiter.com/Images/BCBSMCareers+-+Quick+Reference+Guide.pdf" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="https://ejko.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_3/requisitions" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

keywords: position summary,management,analysis,solutions,strategy,education,experience,knowledge,skills,departmental preferences

Non-Manager

Competitive Total Compensation Package

Overview: <p>Provides technical, data and analytical support to customer departments such as&nbsp; Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment and HCV.</p>
Responsibilities: <ul> <li> <p>Leads or participates, with some direction, in projects where data solutions are necessary.</p> </li> <li> <p>Provides programming and data expertise for simple and moderately complex projects and ad-hoc requests.&nbsp;&nbsp;</p> </li> <li> <p>Presents data and solutions to internal and/or external customers in a logical way.</p> </li> <li> <p>Provides data support and analysis for programs supporting over 4 million BCBSM beneficiaries using administrative claims and supplemental data.&nbsp;</p> </li> <li> <p>Provides analysis and data support for various corporate departments including Quality, Risk Adjustment, Value Partnership, Care Management, and Hospital Contracting, in support of major corporate initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS and NCQA/HEDIS.</p> </li> <li> <p>Standardizes, harmonizes, cleans and shares data with others in the organization as well as external customers.</p> </li> <li> <p>Creates and maintains data-centric product solutions, including third party program integrations such as, HEDIS, risk scores and&nbsp;PGIP incentives l.</p> </li> <li> <p>Supports various reporting activities and continuously strives to make them more efficient and easier for the customers to consume.</p> </li> <li> <p>Completes ad-hoc data and analytic requests assigned.</p> </li> <li> <p>Works with IT and Clinical Data Strategy to maintain and enhance our EMR Clinical Data in the Informatics environment.</p> </li> </ul>
Requirements: <ul> <li> <div class="">Bachelors Degree in Computer Science, Information Systems, Business, Mathematics, Healthcare Information Technology or similar degree required. Master's Degree preferred.</div> </li> <li> <div class="">Minimum 4 years of experience.</div> </li> <li> <div class="">Ability to use advanced functions in SQL or SAS or SPSS programming.</div> </li> <li> <div class="">Solid working knowledge of Microsoft tools and software (i.e., Excel, Visio, Access, PowerPoint).</div> </li> <li> <div class="">Competency in programming concepts such as Visual Basic, Business Objects, .Net, MDX, C++, or COBOL.</div> </li> <li> <div class="">Must possess the ability to help others think critically and share complex technical solutions to non-technical audiences both orally and in writing.</div> </li> <li> <div class="">Must be able to translate thoughts and ideas from non-data customers into data-centric solutions.</div> </li> <li> <div class="">Knowledge of data warehousing and data mining concepts including but not limited to ETL, datamart design, fact tables, dimension tables, data views within data marts/data warehouses, olap, rolap, and data models such as star schemas and snowflake schemas.</div> </li> <li> <div class="">Ability to recognize data patterns, quantify potential issues and identify solutions. Ability to standardize, harmonize, clean, prepare and use data for developing datasets, reporting and analysis.</div> </li> <li> <div class="">Basic understanding of epidemiologic principals and population health management concepts desirable.</div> </li> <li> <div class="">Knowledge of healthcare terminology, plan/benefit design, fundamental operational principles and administrative claims data including standard coding schemes such as ICD-9/10 and HCPCS.</div> <div class="">&nbsp;</div> </li> <li> <p><strong>Departmental Preferences</strong></p> </li> <li> <p>Experience working with EMR/EHR clinical data, including encounters, diagnoses, procedures, medications, labs, vitals, immunizations, and clinical documents.</p> </li> <li> <p>Strong analytical skills with experience using Databricks, SQL and data analysis tools to investigate, validate, and reconcile large clinical datasets.</p> </li> <li> <p>Experience with EMR platforms CCDA data such as Epic, Oracle Health/Cerner, athenahealth, eClinicalWorks</p> </li> <li> <p>Knowledge of C-CDA documents, including clinical data extraction, mapping, transformation, validation, and downstream processing.</p> </li> <li> <p>Experience developing and maintaining data mappings and performing data quality, reconciliation, and root cause analysis for clinical data integrations.</p> </li> <li> <p>Ability to independently execute EMR operational activities, including project planning, status tracking, issue resolution, stakeholder communication, and process improvement initiatives.</p> </li> <li> <p>Experience collaborating with business and clinical stakeholders to identify opportunities for new HEDIS measures, quality programs, and clinical data acquisition efforts.</p> </li> <li> <p>Familiarity with cloud-based data platforms and healthcare interoperability standards (e.g., HL7, CCDA, FHIR), with the ability to analyze EMR/ADT data and develop meaningful reporting and insights.</p> </li> </ul>