Senior Health Care Analyst - Clinical Data Strategy Lead

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,position details,management,performance,analysis,strategy,education,experience,knowledge,skills,departmental preferences

Non-Manager

Competitive Total Compensation Package

Overview: <p>Responsible&nbsp;for&nbsp;planning,&nbsp;organizing,&nbsp;directing,&nbsp;implementation,&nbsp;and&nbsp;leading&nbsp;department&nbsp;assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget.</p> <p>Research,&nbsp;compile&nbsp;and&nbsp;analyze&nbsp;appropriate&nbsp;and&nbsp;relevant data&nbsp;and&nbsp;make&nbsp;recommendations&nbsp;for operational improvements.&nbsp;Within Clinical Data Strategy &amp; Operations team, the position also provides strategic leadership for clinical data acquisition, exchange, interoperability, adoption, governance, and value realization.</p>
Responsibilities: <ul> <li> <p>Leads&nbsp;in&nbsp;the&nbsp;research,&nbsp;analysis,&nbsp;identification&nbsp;and&nbsp;evaluation&nbsp;of&nbsp;data&nbsp;from&nbsp;assigned&nbsp;problems&nbsp;to evaluate existing and potential trends and issues.</p> </li> <li> <p>Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs&nbsp;(including&nbsp;provider&nbsp;data,&nbsp;networks,&nbsp;etc.),&nbsp;corporate&nbsp;organizational&nbsp;structure&nbsp;(including functional responsibilities), and basic research principles/methodologies.</p> </li> <li> <p>Manage&nbsp;and&nbsp;monitor&nbsp;multiple&nbsp;projects&nbsp;simultaneously&nbsp;by&nbsp;establishing&nbsp;project&nbsp;plans&nbsp;and&nbsp;objectives to ensure goal attainment within defined parameters.</p> </li> <li> <p>Develop lines of communication to discuss/review results of analysis to management via reports/presentations&nbsp;and&nbsp;assist&nbsp;management&nbsp;in&nbsp;implementing&nbsp;programs&nbsp;that&nbsp;provide&nbsp;solutions.</p> </li> <li> <p>Investigate,&nbsp;review,&nbsp;recommend,&nbsp;communicate&nbsp;and&nbsp;implement&nbsp;solutions&nbsp;which&nbsp;identify problems/root cause of issues.</p> </li> <li> <p>Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand&nbsp;of&nbsp;change&nbsp;management&nbsp;and&nbsp;initiate&nbsp;actions&nbsp;needed&nbsp;to&nbsp;plan,&nbsp;organize and&nbsp;control&nbsp;team activities.</p> </li> <li> <p>Independently&nbsp;develop strategies, plans,&nbsp;reports,&nbsp;papers, business cases, decision materials,&nbsp; and/or&nbsp;other&nbsp;materials&nbsp;in&nbsp;a&nbsp;clear&nbsp;and&nbsp;concise manner.</p> </li> <li> <p>Provide&nbsp;expertise strategic&nbsp;guidance and analytic support&nbsp;to department and&nbsp;corporate&nbsp;staff&nbsp;as&nbsp;required.</p> </li> <li> <p>Acts&nbsp;as&nbsp;liaison&nbsp;between&nbsp;corporate&nbsp;business&nbsp;areas&nbsp;and&nbsp;participates&nbsp;in workgroups,&nbsp;&nbsp;committees, governance forums, and cross-functional decision-making forums.</p> </li> </ul>
Requirements: <h2><strong>EDUCATION</strong><strong>&nbsp;</strong><strong>AND/OR</strong><strong>&nbsp;</strong><strong>EXPERIENCE</strong></h2> <ol> <li> <p>Bachelor's&nbsp;Degree&nbsp;in&nbsp;Business&nbsp;Administration,&nbsp;Economics,&nbsp;Health&nbsp;Care,&nbsp;Information&nbsp;Systems, Statistics or other related field is required.&nbsp;Master's Degree in related field preferred.</p> </li> <li> <p>Six&nbsp;(6)&nbsp;or&nbsp;more&nbsp;years&nbsp;experience&nbsp;in&nbsp;related&nbsp;experience,&nbsp;typically&nbsp;in&nbsp;two&nbsp;(2)&nbsp;subject&nbsp;areas&nbsp;(e.g. such as financial analysis, planning, health care economics, health care policy, statistical modeling, business decision support, data strategy, interoperability, health plan operations, or business management).</p> </li> <li> <p>Experience developing strategies, roadmaps, business cases, recommendations, and executive presentations is preferred</p> </li> </ol> <p>&nbsp;</p> <p><strong>QUALIFICATIONS</strong></p> <p>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.&nbsp;The requirements listed below are representative of the knowledge, skill, and/or ability required.&nbsp;Reasonable&nbsp;accommodations&nbsp;may&nbsp;be&nbsp;made&nbsp;to&nbsp;enable&nbsp;individuals&nbsp;with&nbsp;disabilities&nbsp;to&nbsp;perform the essential functions.</p> <h2><strong>OTHER</strong><strong>&nbsp;</strong><strong>SKILLS</strong><strong>&nbsp;</strong><strong>AND</strong><strong>&nbsp;</strong><strong>ABILITIES</strong></h2> <ol> <li> <p>Excellent&nbsp;analytical, strategic&nbsp;planning, problem&nbsp;solving,&nbsp;verbal&nbsp;and&nbsp;written, presentation and stakeholder-management&nbsp;skills&nbsp;to&nbsp;communicate&nbsp;complex ideas.</p> </li> <li> <p>Excellent&nbsp;knowledge&nbsp;and&nbsp;use&nbsp;of&nbsp;existing&nbsp;software&nbsp;packages&nbsp;(PowerPoint,&nbsp;Excel,&nbsp;Word,&nbsp;etc.).</p> </li> <li> <p>Strong&nbsp;working&nbsp;knowledge&nbsp;of&nbsp;data&nbsp;languages&nbsp;such&nbsp;as&nbsp;SAS&nbsp;or&nbsp;SQL.</p> </li> <li> <p>Ability&nbsp;to&nbsp;work&nbsp;independently,&nbsp;within&nbsp;a&nbsp;team&nbsp;environment&nbsp;and&nbsp;communicate&nbsp;effectively&nbsp;with employees at all levels.</p> </li> <li> <p>Knowledge of clinical data exchange, FHIR, APIs, healthcare data standards, interoperability workflows, data governance, HEDIS, digital quality, risk adjustment, care management, utilization management, or provider engagement is preferred for the departmental assignment.</p> </li> <li> <p>Other&nbsp;related&nbsp;skills&nbsp;and/or&nbsp;abilities&nbsp;may&nbsp;be&nbsp;required&nbsp;to&nbsp;perform&nbsp;this job.</p> </li> </ol> <p>&nbsp;</p> <p><strong>DEPARTMENTAL PREFERENCES</strong></p> <ul> <li>Demonstrated experience developing or advancing clinical data strategies, roadmaps, priorities, and investment recommendations related to data acquisition, exchange, governance, standardization, interoperability, and enterprise use.</li> <li>Knowledge of healthcare industry trends, regulatory developments, interoperability capabilities, vendor solutions, and methods for assessing current-state gaps and future-state opportunities.</li> <li>Experience with EMR/EHR or HIE connectivity initiatives and solutions such as Epic Payer Platform, AthenaPayer, Healow Insights, Oracle Health, Veradigm, or comparable platforms.</li> <li>Experience supporting or leading complex, cross-functional clinical data or interoperability initiatives from planning through implementation and optimization.</li> <li>Experience establishing or supporting governance structures, business standards, decision frameworks, and accountability for data or interoperability initiatives.</li> <li>Demonstrated ability to facilitate alignment and influence decisions across business, technology, analytics, compliance, privacy, legal, provider engagement, operations, and vendor stakeholders.</li> <li>Strong executive communication and presentation skills, including communicating strategy, performance, risks, recommendations, and decisions to leadership and governance forums.</li> <li>Experience defining or monitoring business outcomes, adoption measures, data-quality indicators, and value metrics for clinical data, interoperability, or other enterprise initiatives.</li> <li>Ability to evaluate solution effectiveness and recommend enhancements that improve data availability, timeliness, completeness, usability, scalability, reuse, adoption, and operational effectiveness.</li> <li>Analytical and problem-solving skills necessary to connect clinical data capabilities to quality improvement, risk adjustment, provider engagement, care management, utilization management, digital quality, or other enterprise priorities.</li> <li>Experience supporting strategic relationships with EMR/EHR, HIE, data, or technology vendors and external partners.</li> <li>Ability to assess vendor capabilities, roadmaps, delivery performance, strategic fit, dependencies, and material risks, and to communicate findings through appropriate governance channels.</li> </ul>