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Blue Cross Blue Shield of Minnesota Healthcare Analyst ERA Pr in Eagan, Minnesota

About Blue Cross Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.9 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. How Is This Role Important to Our Work? This position will support Enterprise Risk Adjustment (ERA), a Stella Program responsible for optimizing risk adjustment revenue through closing gaps and risks in coding and care delivery across Blue Cross' Medicare, Medicaid, and ACA populations. Specifically, this position is responsible for business intelligence and analytics related to Enterprise Risk Adjustment. The applicant will achieve success using a combination of traits and skills including industry knowledge of Risk assessment and Risk Adjustment knowledge domains, data and programming savvy, math and statistical abilities, and a spirit of creativity and problem-solving to deepen insights into the factors that drive health care quality and risk adjustment outcomes. A successful applicant will work independently as well as collaboratively with cross-functional teams to initiate, plan, and lead analysis from conceptual development to conclusion. The position will lead efforts with coworkers, internal business partners, and leadership to clarify requirements, analyze complex data, and produce and present meaningful and defensible results, including the identification of success factors and barriers, improvement opportunities, proposing solutions, and informing strategic decisions. The individual will also drive action based on the results obtained. The Healthcare Analyst Principal will represent the department on both internal and external initiatives. They may also lead project teams. The incumbent will lead efforts to define meaningful contributions that will influence strategic decision-making and the optimization of Stars/Risk/Quality analytics at Blue Cross Blue Shield of Minnesota. A Day in the Life: Develops and works with structured data files from multiple internal sources, such as enrollment data, clinical and pharmacy claims data, risk adjustment data, and other types of data. Independently manages the retrieval of data from a healthcare data warehouse and other sources. Uses business intelligence, statistical, and/or data science techniques to analyze data to guide and evaluate risk adjustment activities. Identifies issues to be investigated and leads or works collaboratively to define and implement a solution. Clearly collaborates and communicates results to non-technical audiences, including producing easy-to-understand representation of the results. Collaborates with other areas within Blue Cross, especially Stars, Enterprise Risk Adjustment, and Quality and Actuarial areas. Produces regular and ad-hoc reports for business stakeholders to enable risk adjustment optimization across multiple lines of business. Reports results on risk adjustment-related outcomes, identifies needs and opportunities for improvement, and interprets results for stakeholders. Represents the division on corporate projects and may have leadership roles on these teams. Independently manages issues that may arise on multiple tasks or projects with limited or no management involvement. Acts as a resource and/or mentor for other members of the department and company on business issues and may be responsible for training and guidance of other employees. Formulates strategic recommendations and present findings to management and external clients. Serves as an analytic consultant who can explain complex measurement or analysis techniques and results in layman's terms. Nice to Have: Masters degree or ASA/FSA preferred. Knowledge of managed care and healthcare claims preferred. Knowledge of Tableau or other data visualization software preferred, with expertise or an interest in developing programming skills Demonstrated understanding of risk adjustment and

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