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Senior Analyst-Senior Health Services/Risk Adjustment

Blue Cross Blue Shield of Michigan
Full-time
Remote
United States
$62,000 - $103,700 USD yearly
IT/Tech
Description

The Medicare Risk Adjustment department is seeking a Senior Risk Adjustment Analyst to join the Encounters and Analytics team.  Our team develops and supports prospective programs, retrospective programs, centralized document repository, and encounter oversight.  A successful candidate will leverage skills within SQL, Python, and Tableau to achieve the operational goals of the department.

 

SUMMARY: 

The Senior Analyst is an analytical role responsible to coordinate the development and implementation of programs and strategies to improve service to our customers.

 

RESPONSIBILITIES/TASKS: 

• Develops and improves work flows and business processes within area(s) to improve customer 

service, decrease operational costs, and improve overall quality.

• Identifies and/or analyzes business problems and devise procedures for solutions to the problems.

• Effectively leads projects in order to produce desired results.

• Responsible for corporate communication of project results.

• Recommends and assists with implementing standard policies and procedures.

• Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.

• Participates in systems testing, develops procedures/controls, and provides recommendations for 

the ongoing improvement of the updated process.

• Assists personnel (both internal and external) by answering questions, supplying information, and training.

• Develops and maintains an effective working relationship with customers.

• Participates in group or committee discussions.

 

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

 

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor’s degree in a related field. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

 

Experience may be accepted in lieu of degree.

 

EXPERIENCE:

Two (2) to four (4) years experience in related field. Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.

 

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: 

  • Analytical, organizational, planning and problem solving skills

  • Understanding and knowledge of the business, products, programs, corporate organizational 

  • structure (including functional responsibilities), and basic research principles/methodologies

  • Ability to plan, organize, direct, and control projects.

  • Excellent written and verbal communication skills.

  • Ability to lead and contribute to process improvement projects.

  • Ability to read and interpret documents such as data flows, process flows, technical diagrams,operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

  • Administer and adhere to corporate and departmental policies, practices and procedures. 

WORKING CONDITIONS:

 Work is performed in an office setting with no unusual hazards. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. PAY RANGE: Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $62,000 and $103,700.

 

EEO Statement: 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. Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.