Job Description

Awarded the Best Place to Work 2021, 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.

This position is remote within the state of AZ only.  This remote work opportunity requires residency, and work to be performed, within the State of Arizona.

Purpose of the job

Provide strategic analysis and operation support that impacts business decisions, improves efficiency, and drives innovation for the Federal Employee Program (FEP) Quality Improvement Team. Perform data extraction, data analysis, analytical model development, as well as production of various reports to support quality improvement strategies and initiatives.  Execute complex analyses that guide the development of key Healthcare and Data Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) activities. This position will be responsible for identifying and quantifying key drivers, investigating areas of opportunity, evaluating effectiveness, and making recommendations. The incumbent will be relied upon to apply business knowledge to analytics projects and provide value-added insights to impact business outcomes.

Qualifications

REQUIRED QUALIFICATIONS

Required Work Experience

  • 1 year using advanced SAS or SQL procedures and/or data mining
  • 2 years of experience working with data visualization tools such as Power BI, or Tableau
  • 3 years of experience working for a healthcare organization/health insurer in data analysis using analytic tools and processes
  • 3 years of experience managing healthcare analytics-based data sets in a hospital or insurance plan environment

Required Education

  • High School Diploma or GED in general field of study

Required Licenses

  • N/A

Required Certifications

  • N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

  • 1 year of HEDIS®, Population Health, CMS Shared Savings, Accountable Care Organization, or Stars data analysis

3 years of experience working for a healthcare organization / health insurer, including development of business analytics and financial impact analyses

Preferred Education

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

Preferred Licenses

  • N/A

Preferred Certifications

  • N/A

ESSENTIAL job functions AND RESPONSIBILITIES

  • Provide accurate, timely and reliable delivery of quality data, metrics, reporting, and analysis in support of FEP quality improvement goals, mandates, and legislation
  • Participate in the FEP QCR postmortem analysis to increase rates and evaluate and analyze annual FEP Quality, Customer Service, and Resource Use (QCR) rates
  • Assist in coordinating new enhancements, including system enhancements and report generation, to improve FEP quality performance scores
  • Create ad-hoc reports to assist with the tracking of the FEP quality metrics
  • Demonstrate and maintain current working knowledge of the required BCBSAZ and FEPDO systems
  • Utilizes software programs including, but not limited to, Excel and other internal and external business intelligence tools to extract, transform, analyze, and report data.
  • Creates and modifies code/formulas/queries, as needed to execute projects to specifications, and assists in the development of projects and initiatives
  • Interprets data accurately and produces clear and comprehensive written analyses, visualizations, tables, etc. for diverse internal and external audiences
  • Supports data collection (including medical records), qualitative and quantitative analysis and transformation into information that can be reported to committees and work groups to identify opportunities for improvement
  • Supports FEP quality improvement workgroup activities, operations, and special projects as needed
  • Develop and analyze business performance reports (e.g. for claims data, provider data, utilization data) and provide notations of performance deviations and anomalies
  • Partner with FEP quality improvement peers and leadership to establish, evaluate, and continually improve measurement methodologies, while adhering to nationally accepted analytic and reporting standards
  • Act as a liaison to both internal business partners and external providers or vendors related to quality data
  • Interpret, communicate, and present results to all levels of management in consistent and easy to understand formats to facilitate fact-based decision making
  • Complete projects within preset timelines and report status to leadership and peers
  • Prepare written documentation on projects to provide a peer review trail and ensure continuity and integrity
  • Build and maintain close working relationships with internal stakeholders and key, external client contacts (e.g. FEP Field Service Team, Operations, Disease Management, Care Management, and other applicable multidisciplinary teams within BCBSAZ)
  • 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
  • Serve as subject matter expert for FEP quality performance data
  • Make sound assumptions and fact-based recommendations and discuss with FEP manager, or quality improvement peers
  • 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.
  • May require some out-of-state travel

competencies

REQUIRED COMPETENCIES

Required Job Skills

  • Intermediate PC proficiency
  • Intermediate proficiency in database, presentation, spreadsheet, and word processing software
  • Intermediate proficiency with development, testing, and management of Tableau/ Power BI (preferred)Dashboards
  • Intermediate proficiency in computer programming, including SAS/SQL and other business intelligence programs
  • Intermediate understanding of data management principles
  • Advanced skills in mathematics and statistics
  • Strong organizational skills
  • Strong written and verbal communication skills
  • Ability to effectively communicate with providers, vendors and other external and internal customers

Required Professional Competencies

  • General knowledge of the healthcare industry
  • Analytical knowledge necessary to generate analytic solutions.
  • Ability to solve problems independently and draw accurate conclusions from data using basic analyticaltechniquesAbility 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 limitingtime constraints
  • Ability to maintain confidentiality and privacy
  • Ability to communicate effectively, both orally and in writing, to all levels in all departments
  • Proactive about requesting enough information to fully understand and meet the business need
  • Interpret results of implemented practices, analyzing impacts, and recommending solutions
  • Interpret and translate policies, procedures, programs, and guidelines
  • Establish and maintain working relationships in a collaborative team environment
  • Self-starter who will use various resources to advance their knowledge base or find solutions

Required Leadership Experience and Competencies N/A

PREFERRED COMPETENCIES

Preferred Job Skills

  • Knowledge of HEDIS reporting and NCQA HEDIS Data Specifications
  • Advanced proficiency in spreadsheet, database, and word processing softwareIntermediate proficiency working with data warehouses and query tools / design
  • Advanced proficiency with development, testing, and management of Tableau/ Power BI (preferred)Dashboards
  • 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 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
  • 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

Preferred Leadership Experience and Competencies

  • N/A

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 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.

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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