Senior Health Care Analyst HEDIS

Responsible for planning, organizing, directing, implementation, and leading department assignments.  Position operates within broad objectives to ensure optimum utilization of manpower and budget.  Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements.

• Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues.
• Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.
• Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.
• Develop lines of communication to discuss/review results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions.
• Investigate, review, recommend, communicate and implement solutions which identify problems/root cause of issues.
• Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities.
• Independently develop and plan, reports, papers and/or other materials in a clear and concise manner.
• Provide expertise and guidance to unit and corporate staff as required.
• Acts as liaison between corporate business areas and participates 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.
• Six (6) or more years experience in related experience, typically in two (2) subject areas (e.g. financial analysis, planning, health care economics, health care policy, statistical modeling, business decisions, analysis, or business management).
• Excellent analytical, planning, problem solving, verbal and written skills to communicate complex ideas.
• Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
• Strong working knowledge of data languages such as SAS or SQL.
• Ability to work independently, within a team environment and communicate effectively with employees at all levels.
• Other related skills and/or abilities may be required to perform this job.

Department Summary / Preferences:

The HEDIS Data Operations and Analytics team is responsible for generating HEDIS (Healthcare Effectiveness Data and Information Set) rates to support enterprise-wide analytics and reporting. Our team plays a critical role in enabling data-driven decision-making across the organization. We collect, analyze, and disseminate HEDIS data to inform business strategies, identify areas for improvement, and track progress towards quality goals.

As a key part of our team, the Senior Analyst will support the development and implementation of HEDIS analytics to meet the evolving needs of the enterprise. This includes collaborating with internal stakeholders to provide data insights and recommendations to drive quality improvement initiatives, as well as working with external vendors to share HEDIS data and support improvement programs. The Senior Analyst will also contribute to the evaluation of these initiatives, helping to assess their effectiveness and identify opportunities for further improvement.

Here are some preferences, but not deal breakers.

• Previous experience with data-driven program evaluation through advanced data analysis, statistical modeling, and epidemiologic study design.
• Previous experience with reporting and analytics utilizing tools like Tableau, SQL, SAS, or Python.
• Previous experience working in databricks.

Strong organization, planning, and project management skills

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.