Responsible for planning, organizing, directing, implementation, and leading department assignments. The 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.
- Leads in the research, analysis, identification, and evaluation of data from assigned problems to evaluate existing and potential trends and issues.
- Possess and maintain 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 the results of the analysis to management via reports/presentations and assist management in implementing programs that provide solutions.
- Investigate, review, recommend, communicate, and implement solutions that identify problems/root cause of issues.
- Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand for 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.
Responsible for reimbursement processes, program maintenance, evaluation, and analytics related to reimbursements and programs for the Physician Group Incentive Program.
- Develop lines of communication to discuss/review the results of the analysis to upper management via reports/presentations and assist leadership in implementing programs that provide solutions.
- A high degree of leadership, evaluative, analytical, and problem-solving skills required.
- Ability to manage multiple projects and to work with internal and external clients to identify needs and develop solutions.
- Experience producing reports and presentations.
- High accuracy and attention to detail.
- Understanding of provider reimbursement and incentives.
- Strong process improvement skills.
- Experience in project readiness activities, such as training, documentation, process evaluation.
- Solid presentation skills to various audiences.
- Strong written and verbal skills.
- Experience with Portico, NASCO, and MOS.
- Basic knowledge of Value Partnership programs or PGIP.
- 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.