Stars Business Analyst - Medicare Advantage
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
Position will collaborate with Star Program team to support the organizational goal of 4-Star Medicare Advantage plans. This will include vendor management, program development, program launch and process improvement activities. Stars Business Analyst will have strong analytic skills and communication skills develop and execute strategies, projects and programs that optimize performance across our provider network and membership. Position will consult with internal and external stakeholders on Stars performance improvement, including member and provider engagement.
Essential Job Functions & Responsibilities
• Partner with Stars leadership to utilize performance analysis methods to identify and recommend opportunities for improvement across Stars program measures.
• Monitor and evaluate progress against timelines, project milestones and key deliverables for HEDIS, Pharmacy, Operations, CAHPS, HOS and improvement measures.
• Assist in development and maintenance of work plan for improvement of Star Rating as well as project specific reporting for status updates. Coordinate projects, including agendas, meeting minutes and status reports
• Collaborate across business divisions with various departments to track Star program performance
• Collect and Analyze data need to implement and monitor quality improvement initiatives that will achieve Star Program outcomes. Will include activities related to HEDIS, Pharmacy, Operations, CAHPS, HOS and Improvement.
• Participate in the development and support the implementation of member outreach activities to improve performance and member outcomes
• Participate in the development and support the implementation of provider activities to improve performance and outcomes
• Support compliance and MA team understanding of CMS guidance for quality policies, procedures and regulation changes
• Support vendor oversight activities and participate in vendor RFP process and implementations
• Manage and maintain stars training materials
• Maintain collaborative team relationship to effectively and efficiently achieve goals and foster a positive work environment
• Position requires 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
Within BCBSAZ and HCA, it is essential that we create a culture of inclusion and opportunity as well as actively guard against bias of any kind. Discrimination and racism are real. Our aim is to empower every member of our team to engage in our mission of improving health for Arizonans. We believe that the power and perspective of diversity and inclusion is in fact, essential to our success in serving clients, achieving our mission and creating a healthy environment for all.
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
1. Required Work Experience
• 2 years of Medicare Experience
• 2 years of healthplan member services, provider services, quality programs or provider quality experience
2. Required Education
• Bachelor’s Degree in general field of study
3. Required Licenses
4. Required Certifications
1. Preferred Work Experience
• 2 years HEDIS or Stars experience
2. Preferred Education
• Bachelor’s degree in general studies, nursing, or business administration
3. Preferred Licenses
4. Preferred Certifications
1. Required Job Skills
• Advanced proficiency with Microsoft office suite applications
• Excellent written and verbal skills including ability to compose a variant of business correspondence
• Strong organizational and planning skills, including budgeting in an efficient and productive manner
• Working knowledge of HEDIS and Stars programs
• Analytical knowledge and skills to evaluate and make decisions on available information
2. Required Professional Competencies
• Highly developed interpersonal skills and communications skills, with a strong customer service orientation.
• Exudes excellence by setting high standards of performance for self and all coworkers, requires high-quality results and exhibits conscientiousness and high sense of responsibility
• Stimulates creativity with the ability to see broadly outside the typical status quo and is constantly open to and promotes new ideas.
• Excellent trouble-shooting, analytics and problem-solving skills with the ability to create and communicate effective solutions
• Ability to manage multiple tasks simultaneously in a demanding, fast-paced environment while keeping relevant others in the organization informed of progress.
• Ability to successfully work with minimal supervision, seeks out and seizes opportunities, finds way to work through barriers, and takes lead roles in working with key stakeholders and other analysts
3. Required Leadership Experience and Competencies
1. Preferred Job Skills
2. Preferred Professional Competencies
3. Preferred Leadership Experience and Competencies