Sr. Risk Adjustment Data Analyst - 10460

$59,600 - $99,700 yearly
  • Emergent Holdings
  • Remote
  • Oct 31, 2023
Full time Health Care Information Technology Insurance

Job Description

SUMMARY: 

The Senior Analyst is an analytical role responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.

RESPONSIBILITIES/TASKS: 

  • Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.
  • Identifies and/or analyzes business problems and devise procedures for solutions to the problems.
  • Effectively leads projects in order to produce desired results.
  • Recommends and assists with implementing standard policies and procedures. 
  • Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.
  • Participates in systems testing, develops procedures/controls, and provides recommendations for the ongoing improvement of the updated process.
  • Assists personnel (both internal and external) by answering questions, supplying information, and training.
  • Represent and participate in group or committee discussions.
  • Possess and maintain a comprehensive understanding and knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.
  • Recommend, communicate, and implement solutions to identified problems/root cause of issues. 
  • Provides technical, data, and software support.
  • Presents data and solutions to internal and/or external customers in a logical way.
  • Provides documentation, data support, and analysis for usage of departmental sandbox.
  • Creates and maintains data-centric product solutions, including third party program integrations.
  • Supports various reporting activities and continuously strives toward automation.
  • Completes ad hoc data and analytic requests as assigned.
  • Competent in SAS (Base, Macro, Graph, Email); Visio; Visual Basic for automation in Excel, Visio, Access, PowerPoint; SQL (Oracle, SQL/Server); ETL into Oracle; system tools (Windows/Linux command line coding, scheduling programs in both); creation of file structures (flat, delimited, etc.); Visual Analytics tools (Tableau).

This position description identifies the responsibilities and tasks typically associated with the performance of the position.  Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor’s degree in a related field.  Continuous learning, as defined by the Company’s learning philosophy, is required.  Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE: 

Two (2) to four (4) years experience in related field.  Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: 

  • Analytical, organizational, planning and problem solving skills
  • Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.
  • Administer and adhere to corporate and departmental policies, practices and procedures.
  • Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies
  • Ability to plan, organize, direct, and control projects.
  • Excellent written and verbal communication skills.
  • Ability to lead and contribute to process improvement projects. 

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. 

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. 

 PAY RANGE: 

“Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $59,600 and $99,700.”

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis.  Nothing herein is intended to create a contract.