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Senior Enterprise Risk Adjustment Data Analyst
3 months ago
Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.
How Is This Role Important to Our Work?
This position manages semi complex to complex data and information to provide meaningful reporting and results, which influence strategic decision-making and priorities within the Enterprise Risk Adjustment Submissions team. The Sr Analyst works both independently and with the team to plan, initiate and occasionally lead analysis from conceptual development, through the configuration and/or implementation stage. Responsibilities include working within the team to understand business requirements and submissions data management for Medicare using a variety of data sources. The Sr Data Analyst uses a variety of analytical techniques to ensure that the data is answering the right question. The incumbent will be relied upon as a Business Intelligence power user and a data steward for all Encounter Data, providing services to a variety of customers, like the Risk Adjustment team, Actuarial, Analytics, and Operations teams.
A Day in the Life:
- Responsible for creating and managing reporting to measure KPI and operational metrics.
- Assist Submissions Analysts in their review of various submissions reports received from regulators and reconcile internal data against submitted data.
- Create tools and reporting to measure the accuracy and effectiveness of our current data submissions processes.
- Assist in the development of recommendations to solve complex problems and issues related to Encounter Data Submissions operations
- Research, analyze, and interpret Encounter Data and provides technical assistance to team and other departments.
- Identify issues and opportunities, determine affected transactions, estimate the impact, and assist in the resolution.
- Prepare presentations for report out of findings to leadership
- Create and maintain reporting of vendor/partner data and measure accuracy of vendor data. Provide reporting to Risk Adjustment leadership and Vendor Management Office as applicable
- Actively participates and leads assigned workgroups, committees, and project implementations
- Independently manages the retrieval and analysis of data on multiple projects with little or no management involvement.
- Act as a resource for other members of the department/division on business issues related to submissions data.
- Serves as an Encounter data consultant for key internal stakeholders.
- Develops meaningful reporting programs in a variety of reporting and analytic tools, integrating multiple data sources together.
- Assists co-workers in using data/information in new and innovative ways.
- Mentor people across the organization on data sources, how to access data sources and the best source to access to meet data needs.
Nice to Have:- Bachelor's degree.
- Encounter Data submissions experience with a focus on Medicare Advantage
- Knowledge of manage care and health care claims preferred.
- Experience creating and maintaining reporting in Power BI
Required Skills and Experiences:
- 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
- Knowledge of Blue Cross legacy and contemporary data sources.
- Proven experience in working with customers across the enterprise to understand business questions and to develop reporting and analytical solutions in support of those questions.
- Demonstrated ability to design, evaluate and interpret complex data sets.
- Strong analytic and problem-solving skills.
- Demonstrated ability to present complex technical information to non-technical audiences and executives.
- Demonstrated ability to work independently and in a team setting with individuals having diverse professional backgrounds including business, technical and /or clinical.
- Proficiency in Microsoft software application such as Word, Powerpoint, Excel, Access.Make A Difference
Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.
Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.
All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
