Hybrid Analyst - Payment Integrity Unit chez Blue Cross Blue Shield of Michigan Mutual Insurance Company
Blue Cross Blue Shield of Michigan Mutual Insurance Company · Detroit, États-Unis d'Amérique · Hybrid
- Junior
- Bureau à Detroit
Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.
- Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance.
- Compile and analyze operational data to identify and resolve business problems.
- Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
- Provide leadership team with status updates on projects and issues.
- Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures.
- Create and present reports and presentations to display operational data and propose business changes.
- Provide support to both internal departments and external entities by answering questions, supplying information and training.
- Participate on special projects or workgroups as assigned.
"Qualifications"
- Bachelor's Degree in a related field is preferred.
- Two (2) years of experience in a related field is required.
- Effective verbal, written communication and interpersonal skills.
- Ability to work independently or in a team environment and interact with all levels of the organization.
- Effective analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
- Organizational skills and ability to prioritize; must be able to coordinate multiple activities with varying timelines.
- Proficient in Microsoft Office suites.
- Ability to develop and maintain effective working relationships.
Departmental Preferences:
- Knowledge of BCBSM and/or Blue Cross Blue Shield Association guidelines and regulation knowledge is
preferred. - Payment integrity systems knowledge is preferred.
- Experience with data analytics (SQL, MS Access, Web Portals), reporting and inventory management is preferred.
- Artificial Intelligence (AI): Experience with AI technologies, with a focus on applications in IT and Healthcare IT.
- A foundation in AI concepts and techniques. Experience of applying AI to solve real-world problems in IT, such as predictive maintenance, anomaly detection that improve healthcare outcomes, and reduce costs is preferred.
- Experience in NASCO 3270 is preferred.
- Macro Development: Ability to design, develop, and implement new macros to automate tasks and improve processes is preferred.
- Process Improvements: Proven experience in analyzing and improving business processes, with a focus on efficiency, productivity, and quality is preferred.
Data Visualization: Experience with data visualization tools, including:
- Tableau: Knowledge of Tableau's data visualization and business intelligence capabilities, including creating interactive dashboards and stories is preferred.
- Power BI: Familiarity with Power BI's data visualization and business analytics features, including creating reports, dashboards, and datasets is preferred.