5 days old

CPI Analyst Senior (ITS)

BCBSM
Grand Rapids, MI 49503
  • Job Code
    BCN0013M

Blue Care Network of Michigan

Analyst Senior

GRAND RAPIDS, MI (CASCADE)


Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.


  • Identify and analyze operational data and develop insights in support of business objectives.

  • Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.

  • Identify and/or analyze business problems and develop recommendations for solutions to problems.

  • Lead the development and implementation of projects and/or teams in order to produce desired results.

  • Document and communicate project concepts, milestones and results.

  • Recommend and assist with implementing standard policies and procedures.

  • Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.

  • Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.

  • Provide support to internal departments and external entities by answering questions, supplying information and training.

  • Create and present reports and presentations to display operational data and proposed business changes.


  • Bachelor's Degree in a related field is preferred.

  • Four (4) years of experience in a related field is required.

  • Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.

  • Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.

  • Excellent verbal, written communication and interpersonal skills.

  • Ability to lead and contribute to business unit and/or corporate projects.

  • Proficient in Microsoft Office Suites.

  • Ability to develop and maintain effective working relationships.


DEPARTMENT REQUIREMENTS:

  • One (1) year Analyst experience required or three (3) years of Non BCBSM/BCN with proven experience in problem analysis, data analysis, root cause identification, document and problem resolution activities.
  • Ability to develop creative solutions to claims business issues.
  • Highly organized, self-starter with proven ability to produce high quality output.
  • In addition to strong organizational skills, must have follow-through abilities with particular attention to detail required.
  • Ability to work effectively with multiple internal clients and to handle multiple projects and implementation time-frames with minimal supervision.
  • Proficient in Microsoft Suite:Word, Excel, PowerPoint and Outlook.
  • Basic knowledge Access or Visio.

DEPARTMENT PREFERENCE:

  • Working knowledge of GovernmentPrograms and/or COB.
  • Experience working in the health insurance industry highly preferred
  • Three (3) years recent proven experience in MACESS/FIS and FACETS/COGNIZANT.
  • One (1) year of experience working in BlueCard or Medicare Advantage.
  • Experience with Optum Pricing, B2 Blue Squared, Winstrat (Optum), Facets, ITS Database, ESRD, Home Health and SNF pricers
  • Processing for commercial and BCNA Experience highly preferred
  • BlueCard or Medicare Advantage experience highly preferred

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.







Posted: 2020-06-29 Expires: 2020-07-28
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CPI Analyst Senior (ITS)

BCBSM
Grand Rapids, MI 49503

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