Job Description

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.

Purpose of the Job

The primary purpose of this position is to perform data/process analysis and implement approved solutions.  This position is responsible for overall data analysis, trending, exception research, data reconciliation, and final reporting segment leadership via dashboard reporting. Implement process improvements for multiple segments that will have a positive impact on the customer associated metrics.  Bring to area management any best practices that can be evaluated and subsequently implemented. The individual will continuously review and develop optimal data metrics and measures on how it results in higher satisfaction with BCBSAZ and with our members.

Essential Job Functions and Responsibilities

  1. Perform data trending activities using established quality assurance methods.  In addition, will write/run non-routine queries against the data to perform further analysis.
  2. Perform member metric trending using established quality assurance methods.  Recognize and raise visibility of data variances and anomalies prior to the release of data.
  3. Perform relational validations on data records to determine if all attributes of data elements are not in conflict with one another.
  4. Partner with business owners to design solutions and present to Customer Metric Committee along with projected benefits
  5. Own all Customer Metric Approval Committee assigned projects from inception to implementation
  6. Track impact of all implemented projects on targets customer metrics and asses their effectiveness
  7. Investigate data issues found through analysis of reporting.
  8. Research, document, and resolve all data related inquiries received from either internal or external customers. Create and facilitate the resolution of data issues and/ or investigate requests from other departments as directed by management.
  9. Analyze data output and recommends changes and enhancements to existing reporting, business, procedures and business rules.
  10. Suggest alternative methods and procedures in solving problems and meeting changing measurement and data needs.
  11. Analyze reports and data for aberrancies, reasonability and accuracy and provide recommendation for problem resolution to management.
  12. Perform high level and detailed analyses on metrics to identify patterns and trends that do not support desired results.
  13. Define and establish data measurement policies. Provide education of these policies to internal and external customers.
  14. Work with internal teams to determine best practice for processes that impact the customer experience.
  • Proactively identify continuous process improvements and work with team(s) to implement. Participate in or lead medium to large projects.
  • Serve as primary contact for internal and external customers when needed or in the absence of manager.

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.

Skills / Requirements

Required Work Experience

  • 3 years of experience in data mining and reporting
  • 3 years of experience in process improvement
  • 3 years of experience in quality management or operations field

Required Education

  • High-School Diploma or GED in general field of study

Preferred Work Experience

  • 5 years of experience in a healthcare related field
  • 5 years of experience in a research, computer science, reporting and/or statistical field
  • 5 years of experience in process improvement implementation

Preferred Education

  • Associate's Degree in business, computer science, mathematics, or statistics field of study

Preferred Licenses

  • N/A

Preferred Certifications

  • Six Sigma Green Belt Certification

Required Job Skills

Required Professional Competencies

  • Strong data mining and analysis skills
  • Strong analysis skills in observing and documenting processes at a detailed level
  • Detail-oriented with ability to question existing data parameters, definitions and data flows, then track an issue back to its source
  • Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
  • Capable of investigative and analytical research
  • Strong organizational and planning skills
  • Proficiency in process improvement
  • Advanced skills in influence, persuasion, negotiation, and problem resolution
  • Strong project management skills
  • Strong understanding of how standard Insurance Policies work.

Required Leadership Experience and Competencies

Preferred Job Skills

  • Intermediate programming language and operating systems
  • Advanced word processing, spreadsheet, database, analytic and reporting software
  • Intermediate mathematics

Preferred Professional Competencies

  • Strong understanding of the service that Health Care professionals provide.

Preferred Leadership Experience and Competencies

  • Facilitate and resolve customer requests and inquiries for all levels of management within the Corporation.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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