Health Care Analyst presso Blue Cross Blue Shield of Michigan Mutual Insurance Company

Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.  Coordinate projects for senior management.

• Research, analyze, identify, and evaluate data from assigned problems to evaluate existing and potential trends and issues.
• 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.
• Assist in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.
• Communicate results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions.
• Recommend, communicate, and implement solutions to identified problems/root cause of issues.
• Provide expertise and guidance to unit and corporate staff as required.
• Represent and participate in group or committee discussions.

"Qualifications"

• 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.
• Four (4) or more years of experience in related field required.
• Strong communication skills are required to understand, interpret, and communicate ideas.
• Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc).
• Working knowledge of data languages such as SAS or SQL.
• Strong analytical, organizational, planning and problem solving skills.
• Ability to effectively interface with employees at all levels.
• Understand and apply statistical inference.
• Other related skills and/or abilities may be required to perform this job.

Departmental Summary / Preferences:

The role involves supporting the team with the Health e-Blue provider applications, focusing on analyzing clinical data quality metrics to identify trends, track provider performance, and improve HEDIS quality. The key responsibilities of this position include analyzing data from various sources, such as administrative records, electronic health records, registries, and databases.  Additionally, the role requires understanding provider member panels, organizations, and member attribution. The ideal candidate will be familiar with utilizing Agile methodology, Jira, and AI capabilities; experience in these areas is a plus. Other responsibilities include gathering requirements, documenting processes, customer support , and ensuring quality assurance, with prior experience in these areas being preferred. Overall, the position requires a strong analytical mindset and the ability to work with various areas, data sources and technologies to inform quality improvement.

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.