Health Care Risk Analyst

<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="" 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 Total Compensation Package

Overview: The Individual Business Unit (IBU) is seeking a well-rounded Health Care Risk Analyst candidate who is able to combine strong analytical and data modeling skills with a strong sense of general business knowledge. The Health Care Risk Analyst will be responsible for providing support to the Business Performance Manager in the Performance Sustainability department. This department is focused on ensuring that IBU meets its performance targets, specifically those related to product pricing, business line profitability and membership targets. As such, the Health Care Risk Analyst will work closely with IBU business partners in cross-functional areas such as Actuarial, Product, Finance, Sales, and Corporate Strategy/Planning, among others. In order to be effective in this role, the candidate will have a background in actuarial mathematics, finance, business administration, engineering or similar education and work experience in a business analysis role. In additional, the candidate should have excellent communication skills, with an emphasis on being able to communicate his/her findings to a diverse range of audiences. Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions. Coordinate projects for senior management.<br />
Responsibilities: <ul> <li>Support IBU&rsquo;s annual product pricing process, which includes working closely with Actuarial and Finance to support development of key assumptions and models used to develop rates.</li> <li>Develop detailed membership forecasts to support IBU&rsquo;s near-term and long-term goals.</li> <li>Support the annual open enrollment reporting process by driving key insights from analytics on emerging enrollment data (such as identifying specific enrollment/cancellation trends).</li> <li>Research, analyze, identify, and evaluate data from assigned problems to evaluate existing and potential trends and issues.</li> <li>Analyze competitor trends in the Michigan Individual market as they relate to products, pricing, and enrollment in order to shape and inform IBU&rsquo;s strategy.</li> <li>Analyze member level financial and demographic data to support marketing segmentation strategies.</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.</li> <li>Provide expertise and guidance to unit and corporate staff as required.</li> <li>Represent and participate in group or committee discussions.</li> <li>Leadership responsibility to coordinate the development and implementation of programs and strategies to improve service to our customers.</li> <li>Develop and improve work flows and business processes within area(s) to improve customer service, decrease operational costs and improve overall quality.</li> <li>Identify and/or analyze business problems and devise procedures for solutions to the problems. Effectively lead projects/teams in order to produce desired results.</li> <li>Responsible for corporate communication of project results.</li> <li>Recommend and assist with implementing standard policies and procedures for providing routine service.</li> <li>Assure that corporate compliance is communicated, implemented and monitored on an ongoing basis.</li> <li>Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.</li> <li>Assist personnel (both internal and external) by answering questions, supplying information and training.</li> <li>Develop and maintain an effective working relationship with customers.</li> <li>Other duties may be assigned.</li> </ul>
Requirements: <ul> <li><span style="font-family: arial; font-size: small;">Bachelor's Degree in related field preferred.</span></li> <li><span style="font-family: arial; font-size: small;">Four (4) to seven (7) years experience in related field.</span></li> <li><span style="font-family: arial; font-size: small;">Supervisory and/or Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.</span></li> <li><span style="font-family: arial; font-size: small;">Ability to plan, organize, direct and control projects.</span></li> <li><span style="font-family: arial; font-size: small;">Excellent written and verbal communication skills.</span></li> <li><span style="font-family: arial; font-size: small;">Ability to lead and contribute to process improvement projects.</span></li> <li><span style="font-family: arial; font-size: small;">Working knowledge of PC applications and/or mainframe required.</span></li> <li><span style="font-family: arial; font-size: small;">Other related skills and/or abilities may be required to perform this job.</span></li> </ul> <p><span style="font-size: small;"><strong><u>DEPARTMENT REQUIREMENTS AND PREFERENCES</u></strong></span></p> <ul> <li><span style="font-size: small;">Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is highly preferred.&nbsp;</span></li> <li><span style="font-size: small;">One (1) or more years of experience in related field required. (Two (2) or more years preferred.)</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 Microsoft Office software packages (PowerPoint, Excel, Word, etc).</span></li> <li><span style="font-size: small;">Working knowledge of SAS preferred.</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;">Ability to understand and apply statistical inference.</span></li> <li><span style="font-size: small;">Ability to create models to forecast futures impacts to the business based on market trend changes.</span></li> <li><span style="font-size: small;">Ability to work within the segment and the organization to find, utilize and set up new data sources.</span></li> <li><span style="font-size: small;">Ability to use PowerPoint to &ldquo;tell the story&rdquo; and communicate advanced concepts to a diverse range of audiences.</span></li> <li><span style="font-size: small;">Excellence in identifying, tracking, mitigating and documenting risk/issues, as well as the ability perform detailed root cause analysis.</span></li> <li><span style="font-size: small;">Ability to work in a fast-paced environment and, at times, under tight deadlines.</span></li> <li><span style="font-size: small;">Preferred skills: Knowledge of actuarial concepts, P&amp;L statement analysis, linear and logistic regression, and ability to apply these techniques to a wide array of different data sources.<br /></span></li> </ul> <div><em><span style="font-size: small;">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.</span></em></div>