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Medicare Advantage - Baton Rouge, United States - Blue Cross and Blue Shield of Louisiana
Description
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
The MA Healthcare and Financial Analyst will be responsible for gathering and analyzing financial data, health care utilization and trend reports, generating reports, and contributing to strategic decision-making.
This position will require presenting and acting on insightful data from cross functional business leaders to improve the financial performance of BCBSLA's Medicare Advantage (MA) Line of Business (LOB).This is a collaborative, team focused role requiring a strong business, financial and accounting acumen, and the ability to present the work product in a clear and concise manner.
In addition, this role requires MA healthcare experience, a complete understanding and experience with the MA STARs and Risk Adjustment programs, analytical and critical thinking skills, independent judgement, a strategic mindset, attention to detail, and an ability to multi-task in a growing MA LOB.
The primary goal of the MA Healthcare and Financial Analyst is to evaluate MA performance trends, healthcare utilization and financial data to surface opportunities for performance improvements and develop operational strategies that will support achieving the strategic objectives of the MA LOB.
NATURE AND SCOPE
This role does not manage people
This role reports to this job: SVP, COO Government Business
Necessary Contacts:
The position will advise and support the SVP, COO of Government Business, and work closely with the Medicare Advantage Finance, Actuarial - both internal and external, Health Care Analytics and Quality Improvement, and Business Process and Performance teams.
In order to effectively fulfill this position, the incumbent will interact with the following teams: Finance, Analytics and Quality Improvement, Government Business units, Strategy and Development, Medical Management, Clinical Solutions, Actuary, Benefit Administration , Provider Engagement and ReimbursementQUALIFICATIONS
Education
Bachelor's in a related field is required.
MBA, MPA, MHA preferred.
Work Experience
5-10 years of experience in a financial or statistical analysis role required. Experience working in a Medicare Advantage organization with understanding of medical trend analysis and the CMS STARs and Risk Adjustment programs required
Skills and Abilities
Must have financial and statistical analysis skills with knowledge of accounting principles.
Critical thinking, analytical and problem-solving skills are required.
Inquisitive, proactive and self-directed.
Proficiency in Microsoft Office applications including Excel, Word, and PowerPoint.
Must have strong verbal and written communication skills to deliver presentations to all levels of leadership. Ability to analyze, consolidate and communicate complex topics to all levels of internal staff and external vendors.
Must have knowledge of query/analytic/visualization tools such as SQL, SAS, Access, R, Tableau, etc.
Must have ability to perform multiple projects in a matrix organization.
Must have the ability to travel to corporate offices as needed.
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Gathers and analyzes financial data, health care utilization and trend reports to contribute to strategic decision-making. Deliver enterprise observations and analysis of operational recommendations and advisory materials into client-facing deliverables.
Support Medicare Advantage business in ad hoc analysis and financial and data analytics development to provide solutions and prioritization of enterprise initiatives.
Perform operational monitoring, assist in bid development, budget development, financial statement analysis, health care cost and trend analysis to support the financial planning and analysis reporting of the organization.
Utilize existing and support the future development of data resources to create actionable plans for achieving and exceeding operational performance targets.
Leads the development of the Total cost of care analysis methodology and prepares dashboards, reports/scorecards for MA line of business.
Participates in identifying and quantifying drivers of cost performance for MA.Participates in the development of the annual budget and budget forecasting.
Provides ongoing data analysis and recommends focus and direction of resources for decision makers and management that is relevant to the MA LOB; leads problem solving, solution development, decision making, and strategic planning.
Analyzes data and recommends changes to resolve problems and leverage technology to improve operational processes, procedures, systems and programs.Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job.
Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functionsPerform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
#LI_CK1
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted.
To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors.
Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions.
As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus.
Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.#J-18808-Ljbffr
