Sr Manager, Analytics for Value Based Care and HEDIS - Hybrid

Blue Cross Blue Shield of Arizona

$110K — $130K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • 3-10 years of experience in data science, analytics, or reporting depending on management level
  • 1-7 years of supervisory experience depending on management level
  • Bachelor's degree in relevant field; Master's preferred
  • Experience in the healthcare industry is a plus
  • Certifications in SAS, Tableau, or actuarial science are advantageous

Responsibilities

  • Manage all daily operations of the Analytics & Data Science department.
  • Ensure that all department documentation and procedures are accurate and up-to-date.
  • Direct and evaluate department performance according to established quality metrics.
  • Provide leadership and mentorship to team members, including performance evaluations.
  • Consult with internal and external partners to optimize analytic solutions.
  • Research and present findings related to healthcare trends and performance metrics.
  • Design and implement custom dashboards for various company areas.

Benefits

  • Flexible working hours and potential remote work options.
  • Opportunities for professional development and continued education.
  • Supportive environment fostering team collaboration and feedback.
  • Comprehensive healthcare benefits and wellness programs.
Full Job Description

PURPOSE OF THE JOB

Manages the day-to-day activities of the Analytics & Data Science department. Serves as the primary contact and resource for staff. Provides oversight, direction, development, problem resolution and leadership for the Analytics & Data Science Team. The team’s responsibilities include: transforming data into meaningful and actionable information for various customer segments; performing strategic data analysis to support medical management programs, quality and value-based partnerships, and a strategic and predictable corporate provider reimbursement strategy; establishing measurement standards; and identifying previously unknown relationships among the data for analyses of trends and healthcare issues.


REQUIRED QUALIFICATIONS

Required Work Experience

  • 3 years of experience in data science, data analytics & reporting or scientific analysis (Sprvsr grades 31-33)
  • 1 year of experience in supervisory/management field and/or project management experience (Sprvsr grades 31-33)

  • 5 years of experience in data science, data analytics & reporting or scientific analysis (Mgr grades 34-35)
  • 3 years of experience in supervisory/management role (Mgr grades 34-35)

  • 10 years of experience in data science, data analytics & reporting or scientific analysis (Sr Mgr grade 36)
  • 7 years of experience in management role (Sr Mgr grade 36)

Required Education

  • Bachelor's Degree in business, mathematics, statistics, healthcare administration or related field of study (All Levels)

Required Licenses

  • N/A

Required Certifications

  • N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

  • 3 years of experience in management/leadership role (Sprvsr)
  • 5 years of experience in management/leadership role (Mgr)
  • 10 years of experience in management/leadership role (Sr Mgr)

  • 1 years of experience in insurance or healthcare field (Sprvsr)
  • 3 years of experience in insurance or healthcare field (Mgr)
  • 7 years of experience in insurance or healthcare field (Sr Mgr)

Preferred Education

  • Master’s Degree in business, mathematics, computer science, or related field of study (All Levels)

Preferred Licenses

  • N/A

Preferred Certifications

  • SAS Certification, Tableau Certification, or Associate, Society of Actuaries (ASA)

 ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
  • Manage the day-to-day operations of the department.
  • Administer, interpret and maintain current working knowledge of the required BCBSAZ systems, procedures, forms and manuals as related to the assigned area of responsibly.
  • Review, update and maintain accuracy of department documentation, computer files, policies and procedures related to the department goals and objectives.  Keep staff informed of new or updated standards, systems, procedures, forms and manuals through staff meetings and verbal and written communications.
  • Direct, evaluate, define and improve the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within department guidelines.
  • Provide guidance, motivation and encouragement to staff, conduct performance evaluations, identify and coordinate training needs, and evaluate and make recommendations in regard to employment decisions.
  • Consult and coordinate with various internal departments, external Blue Plans or business partners and government agencies.
  • Identify/Create the appropriate technical solutions / and address business issues.
  • Monitor external economic and healthcare issues affecting trends, preparing succinct, easy to understand presentations of results and conclusions.
  • Serve as an internal consultant to help define analytic needs and to help end users interpret and apply analytic results.
  • Explore relevant data sources to understand what metrics can potentially be produced. Prepare succinct, easy to understand presentations of results and conclusions.
  • Analyze, interpret and communicate information and present results in formats that facilitate decisions and actions. Aid in the development of new performance measurement tools and approaches and maintain up-to-date knowledge of emerging measurement standards.
  • Evaluate analytical findings to ensure accurate interpretation of data and development of meaningful data mining results.
  • Research latest developments by governmental and national entities (e.g. CMS, NCQA, AHRQ, Leapfrog, etc.) on the establishment of metrics to monitor and/or define provider quality information for the general public. Present findings and recommendations in written and verbal formats.
  • Lead the team in analyzing and mining multiple data sources to select statistically valid data samples; building, testing and implementing statistical models by investigating appropriate methods and algorithms.  Effectively summarize and present findings to Executive Leadership that drive business decisions.
  • Design custom dashboards for various areas in the company. Research and define key metrics and data sources. Monitor for continued effectiveness and opportunities.
  • Identify/Create business tools and analytical solutions to address business issues.
  • 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.


REQUIRED COMPETENCIES

Required Job Skills

  • Intermediate PC proficiency
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones.
  • Basic skill in word processing and presentation software
  • Intermediate proficiency in database, spreadsheet, statistical analysis, query / data mining, and business intelligence software
  • Advanced skill in project management
  • Advanced skill in mathematics and statistics
  • Working knowledge of classification tools (ICD, DRGs, ACGs, ETGs, etc.)

Required Professional Competencies

  • Maintain confidentiality and privacy
  • Communicate professionally to both internal and external customers
  • Analytical skills in observing and documenting processes at a detailed level
  • Proficiency in process improvement and business process design
  • Analyze and research data, propose solutions to resolve issues
  • Ability to use a variety of classification tools and manipulate large quantities of data
  • Establish, contribute and maintain a positive and productive work environment
  • Ability to plan, organize and manage the work of all assigned personnel
  • Advanced knowledge of HRIS systems, employment law, and HR regulations

Required Leadership Experience and Competencies

  • Ability to optimize resources to ensure a cost effective operation.  Includes proactively planning to move staff from one role to another as staffing needs, business priorities or workload changes.
  • Ability to build effective teams
  • Ability to implement new processes and procedures.

PREFERRED COMPETENCIES

Preferred Job Skills

  • Advanced proficiency in database, spreadsheet, statistical analysis, query / data mining, business intelligence software including SAS, and data visualization tools, such as Tableau.

Preferred Professional Competencies

  • N/A

Preferred Leadership Experience and Competencies

  • Ability to establish and maintain professional relationships with community and professional groups which reflect favorably for the department and BCBSAZ

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