Health Care Analyst (EPI / BIO)

<p>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.</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. http://www.bcbsm.com

keywords: management,analysis,risk management,support,teamwork,maintain,consulting,communication,support,research,knowledge,degree,performance,experience,communication,analysis

Full-Time

Competitive Total Compensation Package

Overview: <p>Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.&nbsp; Coordinate projects for senior management.<br /><br />The department is responsible for the development of predictive models for identifying candidates for Care Management (CM) programs. Those candidates are stratified by a combination of risk factors in order to prioritize them for referral to CM programs. The interaction between CM programs, including Case Management, Disease Management, and Care Transitions are handled through a referral process to ensure candidates are targeted in the order of priority within and between programs. The department also supports measurement and evaluation of CM programs using claims, program activity, and other data sources such as laboratory, biometric, Health Assessment, and external sources. Data is integrated from all of these sources for support of program development and delivery as well as evaluation of program effectiveness in terms of health outcomes, program processes, and financial savings of the program.</p>
Responsibilities: <ul> <li>Research, analyze, identify, and evaluate data from assigned problems to evaluate existing and potential trends and issues.</li> <li>Possess and maintain a comprehensive understanding and knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.</li> <li>Assist in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.</li> <li>Communicate results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions.</li> <li>Recommend, communicate, and implement solutions to identified problems/root cause of issues. Provide expertise and guidance to unit and corporate staff as required.</li> <li>Represent and participate in group or committee discussions.</li> <li>Other duties may be assigned.</li> </ul>
Requirements: <ul> <li><span style="font-size: small;">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.</span></li> <li><span style="font-size: small;">Four (4) or more years of experience in related field required.</span></li> <li><span style="font-size: small;">Strong communication skills are required to understand, interpret, and communicate ideas.</span></li> <li><span style="font-size: small;">Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc).</span></li> <li><span style="font-size: small;">Working knowledge of data languages such as SAS or SQL.</span></li> <li><span style="font-size: small;">Strong analytical, organizational, planning and problem solving skills.</span></li> <li><span style="font-size: small;">Ability to effectively interface with employees at all levels.</span></li> <li><span style="font-size: small;">Understand and apply statistical inference.</span></li> <li><span style="font-size: small;">Other related skills and/or abilities may be required to perform this job.</span></li> </ul> <div><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></div>