Senior Health Care Analyst-Health Care Value & Provider Affiliation

Advantasure, Inc.

$85K — $110K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or related field required; Master's preferred.
  • 6+ years of experience, typically in financial analysis, health care economics, or policy-related fields.
  • Strong analytical, planning, and problem-solving skills.
  • Proficient in Microsoft Office suite (PowerPoint, Excel, Word).
  • Knowledge of data languages such as SAS or SQL.
  • Capable of working independently and within teams, promoting effective communication across all levels.

Responsibilities

  • Plan, organize, direct, and implement department assignments.
  • Research, analyze, and evaluate data to recommend operational improvements.
  • Collaborate with cross-functional teams to implement projects.
  • Oversee claims processing for accuracy and adherence to guidelines.
  • Identify and resolve challenges to meet corporate objectives and manage change.
  • Develop and present reports and findings to management.
  • Act as a liaison between various corporate business areas.

Benefits

  • Comprehensive health insurance options.
  • Retirement savings plans with company contributions.
  • Opportunities for professional development and education reimbursement.
  • Flexible working hours to promote work-life balance.
Full Job Description
Job Description

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. Collaborate with teams across the enterprise to implement projects. Oversee claims processing to ensure accuracy while adhering to established guidelines.
  • 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.

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