Senior Business Systems Analyst at Independence Blue Cross LLC in Philadelphia, Pennsylvania

Job Description:

Bring your drive for excellence, team orientation and customer commitment to Independence; help us renew and reimagine our business and shape the future of health care.  Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team.  If this describes you, we want to speak with you.

 Government Markets is hiring a Senior Analyst to join its Risk Data Analytics Team. This professional will be responsible for analyzing and automating a variety of data associated with Risk Adjustment for Medicare Advantage Risk and Commercial - ACA. Using tools including SQL Server, Tableau, SSIS and SSRS, the Analyst will develop clear business specifications, troubleshoot, and recommend solutions to improve the quality of management reporting for Government Markets Unit. The Analyst will also participate in various corporate wide projects that will drive system initiatives and database projects. Advanced analytical, technical, and problem-solving skills needed

Responsibilities:

• Conduct data analysis for a variety of analytic solutions. Capture, develop, and document data definitions, business rules, and data quality requirements. Create and produce forecasts, reports, ad hoc requests, dashboards, etc.


• Interpret data, analyze results, and provide insights to determine operational impact, trends, and opportunities.


• Develop reports and deliverables for management and communicate with all levels of stakeholders. Identify and define both process and data improvements.


• Ensure compliance with deliverable reporting requirements by reviewing and assessing the audit results.  Has the working knowledge to be able to determine what measures to use.


• Apply critical thinking and analysis to the data and reports that are collected.


• Manage data flows from multitude of sources to ensure accuracy and completeness of data received.


• Conduct regular reconciliations with CMS results to optimize revenue projections.


• Work closely with actuarial department to assist with risk score projections used for bids and financial forecasting.


• Analyze complex datasets to identify opportunities for CMS program enhancements.


• Acts as a resource for colleagues with less experience. 

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  Bachelor’s degree in Business, Finance, Information Systems/Science, related field, or equivalent work experience.

  
  


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  Minimum 5+ years of relevant experience.

  
  


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  Advanced Technical skill in:  Tableau; SQL; SSIS; or ETL

  
  


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  Demonstrated strong communication skills

  
  


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  Advanced analytical and problem-solving skills

  
  


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  Demonstrated experience in Microsoft Office Suite; data visualization

  
  


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  Ability to persuade, negotiate and resolve issues.

  
  


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  Ability to define complex business issues and determine "best fit" solutions

  
  


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  Knowledge of CMS Risk Adjustment is a plus.

  
  


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  Knowledge of CMS Medicare, and ACA programs is a plus.

  
  


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  Knowledge of statistical software (R or SAS) is a plus.