Senior Analyst Provider Opps & Innovation at BCBSM in Southfield, Michigan

Job Description:

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.

Department Summary / Preferences:

Provide subject matter expertise, analysis and management of managed care network audits within the department. Communicate results of the analysis to management via reports/presentations and assist management in implementing programs that provide solutions.  Conduct continuous quality improvement and maintenance on existing managed care networks. Collaborate across the department to implement process improvement strategies. Lead cross-functional efforts to contribute to managed care provider inquiry and issue resolution.  Work with internal business partners to ensure delivery against established service level agreements and to establish best practices. Participate in ongoing strategic planning to improve team performance, engagement, provider satisfaction, and product outcomes. Demonstrate effective project planning and business readiness with internal partners to implement new departmental initiatives. Recommend, communicate, and implement solutions to identified problems/root causes of issues

 

Departmental Summary-Experience

Possess and maintain a comprehensive knowledge of BCBSM business, products, provider network, provider data and research principles/methodologies

Physician Organizations, PGIP program and/or BCN Managed Care Groups (MCGs) knowledge preferred

Experience with PORTICO and Facets preferred.

Previous project management experience.

  

Knowledge of BCBSM/BCN enrollment procedures.

Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc).

Ability to manage multiple priorities

Works independently within cross-functional team environment and communicates effectively with employees at all levels.

Strong writing skills with the ability to thoroughly document desk procedures and job aids.

 

• 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.

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.