Your Role

The Provider Partnerships and Network Management team support internal and external value-based processes including platform operations and reporting, vendor management support, and program and project management support for various new Health Reimagined, Provider Partnerships or other internal stakeholder solutions development within the value-based physician reporting and performance data platforms. The Business Analyst, Senior – Value Based Operations will report to the Senior Manager. In this role you will develop, perform, organize, and streamline operational tasks to reduce the potential for errors. Additionally, this role is instrumental in providing technical assistance on the reporting platforms to internal and external stakeholders including ACOs, providers and their staff. The Business Analyst, Senior role will also support interact with stakeholders while supporting programs/projects from initiation through delivery for new functionality within the value-based physician reporting and performance data platforms, such as new payment models and others.

Your Work

In this role, you will:

• Provide basic analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Develop, prepare, analyze, and present reports with complex analysis and data for management review
• Triage email box inquires and distributing to applicable departments for response as needed. Track ACO provider questions, issues, and requests
• Track and manage issues, operational updates, and enhancements for the value-based platforms
• Prepare and distribute monthly files as part of contracting process
• Manage and coordinate monthly processes and interfaces, including BlueCard and Self-Funded payments as well as interfaces with vendors that support the value-based platforms
• Research and answer internal questions related to attribution, care gap, quality, or other provider reporting data
• Monitor and report on status of monthly business processes
• Research and resolve internal/external issues related to reporting
• Provide analytical support for complex cross-functional projects, and coordinating with internal and external resources
• Document and execute operational processes
• Perform other duties as assigned

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires 5 years of prior relevant experience
• Prior experience in the health insurance industry is preferred
• Experience working cross-functionally in analyzing, designing, and developing business solutions is preferred
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, and subject matter experts as well as external customers
• Strong problem solver with demonstrated ability to identify root cause of low complexity issues
• Ability to create “as-is” and “to-be” process flows and keep procedure manuals current
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability
• Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management is preferred
• Advanced skills in database queries is preferred
• Exposure to project tracking tools such as Jira is preferred
• Ability to multi-task and prioritize work autonomously with great initiative and can-do attitude
• Ability to work in a fast-paced environment, with a virtual team and adapt to a culture of learning and innovation

Pay Range:

The pay range for this role is: $77,990.00 to $116,930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate’s experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.