Sr. Analyst - Stars Program

Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.

Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Internal Use Only: Grade 29-30

Purpose of the job

• Provide strategic analysis that impacts business decisions, improves efficiency and drives innovation. Perform data extraction, healthcare cost analysis, analytical model development, as well as production of various reports to support corporate strategies and initiatives. Execute complex analyses that guide the development of reimbursement policy, provider negotiations, network development, value-based care, population health management, utilization management programs and other medical cost containment solutions.

Qualifications

REQUIRED QUALIFICATIONS

Required Work Experience

• 3 years of experience in data analysis using analytic tools and processes

Required Education

• Bachelor's Degree in mathematics, statistics, business, or related field of study

Required Licenses

• N/A

Required Certifications

• N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

• 3 years of experience working for a healthcare organization / health insurer, including development of
• 2 years of experience in Medicare Advantage, HEDIS and/or CMS Stars

Preferred Education

• Masters Degree in mathematics, statistics, business, or related field of study

Preferred Licenses

• N/A

Preferred Certifications

• N/A

ESSENTIAL job functions AND RESPONSIBILITIES

• Serve as an internal analytics consultant to define business questions and transform data and analysis into meaningful and actionable information for a variety of business areas
• Perform complex analyses and interpret complex calculations to recommend actions and solutions
• Develop financial models needed to accomplish analytic goals
• Serve as subject matter expert for internal stakeholders
• Design and deliver self-service business intelligence tools to internal customers
• Make sound assumptions and fact-based recommendations and discuss with supervisor, manager, or project manager.
• Effectively communicate results and recommendations to internal and external customers.
• Provide self- and peer-review of job responsibilities
• Share knowledge of skills, projects, and business needs with peers and less-experienced analysts. Train new analysts.
• Report to a supervisor or manager who provides general supervisory instructions, manages projects and reviews results. Develops own work-plans, and discusses timelines, prioritization, and objectives with supervisor or manager
• Develop annual off -cycle CAHPS survey to support future state CAHPS incentive across provider contracts, including payout of incentives for achieved CAHPS targets
• Develop provider scorecards for quarterly distribution with supporting monthly care gap reporting
• Provider scorecards to appropriately rank provider performance for improvement opportunities
• Develop GeoMapping capabilities to determine geographic improvement opportunities
• Develop incentive report cards (bonus potential, current performance, opportunity). Would include development of annual payout calculations across incentivized measures (HEDIS, Pharmacy, CAHPS)
• Develop Stars Program monthly performance dashboards to manage program performance and projections
• Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
• Perform all other duties as assigned.

Competencies

REQUIRED COMPETENCIES

Required Job Skills

• Intermediate PC proficiency
• Intermediate proficiency in database, presentation, spreadsheet and word processing software
• General proficiency in mathematical concepts
• Intermediate proficiency in computer programming, including SAS and other business intelligence programs
• Intermediate understanding of data management principles
• Advanced skills in mathematics and statistics
• Intermediate skill with SAS/SQL programming
• Advanced understanding of data management principles
• Proficiency in SAS Enterprise Business Intelligence software
• Intermediate skill with data visualization tools, such as Tableau

Required Professional Competencies

• General knowledge of the healthcare industry
• Broad understanding of health insurance terms and concepts
• Analytical knowledge necessary to generate analytic solutions
• Ability to solve problems independently and draw accurate conclusions from data using basic analytic techniques
• Ability to deal with ambiguity and make recommendations with less than complete or conflicting information
• Skill in prioritizing tasks and working with multiple priorities, sometimes under limited time constraints
• Ability to maintain confidentiality and privacy
• Ability to communicate effectively, both orally and in writing, to all levels in all departments
• Ability to distill and communicate financial levers and impacts to non-technical audiences
• Ability to build and maintain productive working relationships with others
• Proactive about requesting enough information to fully understand and meet the business need.

Required Leadership Experience and Competencies

• N/A

PREFERRED COMPETENCIES

Preferred Job Skills

• Advanced proficiency in spreadsheet, database and word processing software
• Intermediate proficiency with data warehouses and query tools / design
• Intermediate skill with data visualization tools, such as Tableau
• Intermediate proficiency with development, testing, and management of Tableau Dashboards
• Intermediate understanding of data management principles
• Advanced skill in database, spreadsheet, business intelligence, statistical, and data cubing software
• Familiarity with provider network design processes and strategies
• Knowledge of health benefit design and rating techniques
• Advanced skills in mathematics and statistics
• Proficiency in SAS Enterprise Business Intelligence software
• Advanced understanding of data management principles

Preferred Professional Competencies

• Project management skill needed to create timelines, track deliverables and progress, resolve issues, and communicate project status

Preferred Leadership Experience and Competencies

• Ability to engage and collaborate with team members and business stakeholders at all levels of the organization
• Ability to make decisions in a timely manner, sometimes with incomplete information and under tight deadlines
• High standard of performance while pursuing aggressive goals
• Principled leadership and sound business ethics

Our Commitment

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank You

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.