Corporate Performance Data Analyst

Position Description:

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

The Corporate Performance Data Analyst works to improve business value utilizing analytical procedures in support of Corporate Performance activities. This includes identifying, defining, and leveraging information solutions to improve organization efficiency, operating effectiveness and analyze emerging trends within claims and other data elements.

This role supports the information, and analytics needs of the Corporate Performance department. Analyzes information requests, designs, and develops appropriate solutions, and leverages analytic tools in support of management's requests. Researches, analyzes, and recommends changes to existing outdated analysis processes. Leverages the tools currently provided and research new products and/or opportunities to increase efficiency.

Responsibilities and Qualifications:

• Develop and enhance new or existing reports and analysis, processes, methodologies, modeling tools to drive optimization of claims audits. Produce qualitative trending and performance analysis for each BCBSA performance program, including FEP.
• Maintain positive relations and manage request from department leadership and Corporate Performance staff through a variety of effective communications to identify and gather appropriate data sources and data elements to support the claims audit process. Assist with required monthly reporting for each program.
• Develop and maintain a successful system of routine data analytics and report logic which will provide an efficient/automated means to analyze and increase testing volumes of data for outliers, anomalies, patterns, and trends. Identify and implement opportunities to automate audit testing and develop techniques and the ability to analyze large volumes of data.
• Assist during the creation of processes, documentation, and reporting infrastructure.
• Review audit processes and supporting documentation to ensure alignment with BCBSA requirements. Assess changes to internal processes and impact to program audits. This will involve reviewing project management office materials for impact to audits and participating in PMO meetings to ensure that business requirements necessary for compliance with BCBSA programs are addressed.
• Develop and oversee quality control of various audits, including self-service, web transactions, claims, correspondence, enrollment and reporting.
• Assist with departmental and organizational special projects.
• Responsibility for maintenance of SharePoint and other internal sites.
• Assist with Board and Committee level reporting, as required.

Skills:

• Strong analytical, written/verbal communication, interpersonal, and relationship building skills. Demonstrated ability to drive results to completion, while managing multiple projects and priorities.
• Demonstrated quantitative, analytical, data-intuition, problem-solving skills, and proficiency in data analytics and automation techniques.
• Ability to engage with stakeholders and transform conceptual thinking into defined and fully executed deliverables.
• Demonstrated knowledge and proficiency in extraction and exploratory analysis of data from a wide variety of data sources, leveraging data analysis, data visualization tools and reporting techniques (e.g., Power BI, SAS, MS Access, Facets, Crystal Reports, SharePoint, etc.).
• Self-management to work autonomously and act with urgency and accountability for completion of assigned deliverables.
• Lead meetings and give presentations to both management and staff.
• Demonstrate the drive, determination, and perseverance to get things done.
• Cultivate and maintain positive working relationships throughout the organization and exercise collaboration skills with all levels of the organization.
• Develop innovative ideas, tools, and approaches related to process evaluation and re-engineering.

Knowledge:

• Proficient knowledge of Healthcare Plan systems, applications, databases, and their underlying data structures.
• Proficient understanding and application of data analysis used in audit. Understanding and application of data analysis used in the support of business process.
• Preferred: understanding of health care information, including exposure to coding standards, billing rules and regulations and understanding of procedure and diagnosis codes (CPT, ICD10 coding, HCPCS and DRGs).
• Preferred: familiarity with BCBSA audit programs, including FEP.

Experience:

• 3 years of experience in any of the following: Data Analytics, Data Visualization, Statistics, Business Intelligence, Auditing, Information Technology, Health Care, Database Management

Education and Certifications:

• Bachelor's degree in data Analytics, Data Science, Finance, Actuarial, Mathematics or Statistics, Health Administration or Business Administration.

Work Environment:

• Working environment includes typical office conditions.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must be able to work over 40 hours per week.
• The employee must occasionally lift and/or move up to five pounds.
• Work requires visual acuity to perform close inspection of written and computer-generated documents as well as PC monitor.

Other:

• Limited travel requirements. Less than approximately 5% on an annual basis.

About Us: We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.