Advanced Analytics Analyst II

The Role

Network Performance Improvement data analysts are responsible for providing data and reporting used to measure quality metrics in support of contracting strategies.   This includes the development and maintenance of data and reporting programs used to support provider arrangements, including risk contracts such as the Alternative Quality Contract (AQC) and expansion into other products/providers (PPO, Medicare, Small Group and Hospital).   

Key Accountabilities:

• Provide expertise in electronic clinical data capture and the development of electronic clinical data reporting and analysis.

• Development of SAS programs which measure quality metrics used in the measurement & evaluation of providers engaged in incentive programs & other quality based contracts
• Troubleshoot production reporting issues, identify root causes and implement necessary coding updates
• Work with complex health care data to develop and produce standard ad hoc reports and analysis including attribution and clinical data collection and reporting
• Analyzes and investigates Quality data as it relates to Quality measurement and other pertinent data to identify areas of improvement
• Assists with research, development, monitoring, and reporting of special projects as requested
• Responsible for developing and documenting project and programming requirements for new and changing quality reporting applications, maintaining proper documentation and back-up for all reporting and data applications

Qualifications:

• Proficiency in writing maintainable, supportable, well-documented SAS code
• Strong quality control ethic, ability to assess accuracy of output at report level as well as investigate potential issues at a granular level.
• Two plus years of experience programming Quality measures.
• Strong focus on data manipulation and ability to drive results to completion with minimal supervision.

• Ability to extract, cleanse, integrate medical and pharmacy claims and membership data from various platforms and sources
• Creative problem-solving skills with strong verbal and communication skills.
• Excellent customer focus and ability to work effectively in cross-functional teams

Education/Relevant Experience:

• 3+ years SAS programming experience required
• 3+ years’ experience analyzing healthcare claims data
• Prior experience working with medical and pharmacy claims data at either a health plan, provider group or health data vendor preferred.
• Development and use of PC applications for data analysis (specifically spreadsheet and database systems (MS Excel, MS Access)
• Prior experience working with medical and pharmacy data at either a health plan or provider group or health data vendor
• Strong knowledge of healthcare delivery systems, provider risk and incentive programs

BA/BS required. Master preferred.

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the posted range, and the range may be modified in the future.  An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note:  No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that the confidence gap and imposter syndrome can  prevent  amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.