Product Affordability Analyst (Healthcare/ Insurance)
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
Performs extensive Individual Segment product and network analyses in support of the total medical cost position through analysis of medical expense reports, drill downs of trend drivers and execution of key initiatives designed to address access, affordability and competitive market positioning.
Essential Job Functions and Responsibilities
LEVEL 1 – Product Affordability Analyst – Individual Segment
- Analyze provider and customer data sets and dashboards to recommend and drive solutions to strengthen the affordability of BCBSAZ Individual Segment product and network offerings
- Identify, analyze, interpret and validate trends and patterns in Individual and Family Plan utilization across provider panels, care settings and other categories, advising segment leadership team of affordability challenges and potential mitigating actions
- Work closely with both Corporate and Segment cost of care management teams to identify new areas of opportunity and incorporate approved initiatives to ensure affordability of BCBSAZ Individual Segment product and network offerings
- Collaborate with Analytics team to design and develop tools and reports that lend valuable insights leveraging a combination of internal and external data
- Collaborate with Analytics and Provider Network teams to identify providers and locations practicing high value care for inclusion in current or future Exclusive Network offerings
- Deliver drill-down analytics in a proactive and timely manner based on emerging results
- Support segment leadership decision-making and adoption of approved cost-savings initiatives by matrix partners
- Create compelling presentations, memos and white papers to put forward proposals and educate the organization
- Act as liaison between Individual Segment and other areas of the organization related to select projects and priorities
- Develop multi-year strategies, priorities and roadmap to optimize Individual Segment product networks
- Serve as product network advocate for segment, creating and presenting promotional messaging and education to internal and external stakeholders
- Drive and bring to market complex and critical initiatives aimed at improving the access and affordability of BCBSAZ Individual Segment product and network offerings with minimal oversight
- Maintain top-level knowledge of competitive, health care delivery and consumer landscapes, identifying market opportunities and competitive gaps
- Each progressive level includes the ability to perform the essential functions of any lower 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.
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
- Level 1: Three years of experience in business analysis, health insurance, product development or related field
- Level 2: Five years of experience in business analysis, health insurance, product development or related field
- All Levels: Bachelor’s Degree in Business, Healthcare, Marketing, Mathematics, Economics, Finance or related field
Preferred Work Experience
- All Levels: Experience with medical cost trend analysis and/or health care provider contract analysis.
- Level 1: Five years of experience in product development or business analysis with a health insurer
- Level 2: Eight years of experience in product development or business analysis with a health insurer
Required Job Skills
- Intermediate PC proficiency
- Intermediate proficiency with Microsoft Office, including Excel, Word and Powerpoint
- Strong research and organizational skills
- Advanced problem-solving and investigative skills
- Ability to communicate effectively, both orally and in writing
- Ability to collaborate with team members and business stakeholders at all levels of the organization
- Basic understanding of provider data and contracting principles
Required Professional Competencies
- Ability to analyze and interpret data
- Ability to work quickly and accurately
- Ability to manage multiple, simultaneous responsibilities
- Ability to cultivate and maintain productive working relationships with business partners
- Ability to make decisions and solve problems while working under pressure
- Ability to work at a high level with minimal supervision
- Advanced analytical skills necessary to generate insights and recommendations based on available data
- Excellent professional and interpersonal skills, including the ability to interface with senior/executive level management
- Excellent presentation and communication skills
- Strong influencing abilities to manage internal partners and ensure promised deliverables are achieved.
- Ability to work at a high level without supervision
Required Leadership Experience and Competencies
- Translate daily work into overall company goals and objectives
- Matrix management skills with the ability to reinforce positive environments
- Ability to make decisions in a timely manner, sometimes with incomplete information and under tight deadlines
- Ability to influence key stakeholders to accomplish key objectives
Preferred Job Skills
- Detailed knowledge of benefit designs especially as it relates to Health Care Reform (ACA).
- Basic understanding of standard medical coding
- Familiarity with provider network design processes and strategies