Lead Health Data Analyst

Pay Range:

Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

At BCBSRI, our greatest resource is our people. 

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.

We recognize that to do your best work, you have to be your best self. 
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.

Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. 

We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

What you will do:

Lead the extraction and analysis of health care data for specific studies and corporate initiatives related to the Total Cost of Care.  Lead data intensive projects related to data exchanges with contracted clinical vendors; Serve as a technical resource to department staff and management on technical issues; Develop and improve automated processes to increase the efficiency and accuracy of work products.

What you’ll need to succeed:   ​

• Develop deep understanding of claims, eligibility and provider data to support clinical vendor implementations and ongoing relationships.  Perform data extraction and mapping activities in alignment with vendor program specifications. Collaborate with vendors to define necessary inbound data elements and facilitate their integration into BCBSRI data structures.
• Drive data discussions to ensure “minimum necessary” data is provided to fully support clinical programs.  Present and defend data requirements at internal Data Governance Committee.
• Triage data discrepancies and expeditiously resolve inconsistencies.
• Perform complex analytical work of health care data.  Utilize data to provide insights about customers and prospects to support the growth of various market segments. 
• Initiate and lead data intensive projects; translate quantitative findings into practical insights through the interpretation of data, trends and other sources.  Prepare project results or recommendations for a wide range of audiences using written reports and presentation exhibits/graphics. 
• Conduct special data extraction and analysis studies.  Summarize results and provide recommendations where appropriate. 
• Design, implement, and maintain various databases as assigned; develop reporting capabilities and ensure data quality and documentation is adequate.
• Identify areas where operational efficiency can be improved through enhanced automation.  Collaborate with technical staff on implementation of enhancements.  Communicate necessary changes and enhancements to all internal/external customers.
• Represent the organization at external meetings.
• Provide recommendations and input to new contract provisions for performance guarantees. Respond to various Requests for Implementation as requested by marketing staff.  Perform special studies as needed.
• Perform other duties as assigned.
• Bachelor’s degree in Computer Science, Mathematics, Economics, or related field; or an equivalent combination of education and experience
• Seven to ten years health data analysis, business analysis, software application, database design, and technical documentation experience, preferably in the health insurance industry
• Successfully pass the Wolfe Spence Programmer Aptitude test
• Knowledge of claims processing and membership processing for all BCBSRI lines of business

The extras:

• Knowledge of applied statistics   
• Knowledge of econometric modeling
• Knowledge of marketing analytic principles and modeling
• Experience utilizing competitive intelligence

• Knowledge of CPT-4 and ICD-9 coding and covered benefits
• Understanding of SAS programming, spreadsheet, and database software and other application development tools
• Knowledge of general mathematical principals
• Working knowledge of Business Objects and Windows
• Understanding of micro and mainframe computer systems
• Strong business acumen and political savvy
• Ability to lead and manage projects
• Ability to collaborate while dealing with complex situations
• Ability to think creatively and to drive innovation
• Ability to motivate, lead and inspire a diverse group to a common goal/solution with multiple stakeholders
• Ability to convert business strategy into action-oriented objectives and measurable results
• Strong negotiating, influencing, and consensus-building skills
• Ability to mentor, coach and provide guidance to others

Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
   

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

The law requires an employer to post notices describing the Federal laws. Please visit  www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.