Senior Healthcare Data Analyst: ACA + EDGE

Blue Cross NC is seeking a highly skilled Senior Data Analyst with expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissions. This role involves serving as a liaison between business stakeholders and technical teams to ensure accurate and timely EDGE data submissions and reporting, while providing complex analytic support for decision making.

Responsibilities:

• Construct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports) to gather statistical data, ensuring that the most efficient procedures are used to access, investigate, and analyze data
• Develop, analyze, report and interpret complex data for ongoing activities/projects. Ensure that all data is accurate and available to meet establish deadlines
• Work collaboratively with customers to complete effective needs analyses to successfully provide analytic support and problem solving assistance to business areas
• Monitor and perform in-depth analysis of data for customers to determine areas of improvement or where investigation is needed
• Identify complex data problems and issues and is responsible for resolution
• Identify complex trends and make recommendations to business areas to effectively assist them with decision making on operational or other business issues
• Communicate meaningful insights by creating charts and slide presentations and presenting findings to all levels of leadership staff
• Maintain and coordinate existing cross-functional programs, and create and develop new programs
• Support and manage complex applications systems on many platforms and manage code migrations and changes between different applications environments
• Develop, maintain, and monitor reports on system security to ensure user access is appropriate for the specific division. Provide ongoing user support for ad hoc reporting, questions, queries, and problem support
• Ensure appropriate security and privacy for all data that contains PHI fields. Resolve all security and privacy issues in the data
• Represent department on enterprise project teams and process optimization efforts as needed
• Serve as a mentor/coach for less experienced employees

Requirements:

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related field
• In lieu of degree, 7+ years of experience in related field
• Deep expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissions
• Strong experience with ACA data flows (enrollment, claims, supplemental)
• HCC modeling and reconciliation of EDGE outputs
• Advanced analytical and data validation skills
• Ability to construct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports)
• Ability to develop, analyze, report and interpret complex data for ongoing activities/projects
• Ability to work collaboratively with customers to complete effective needs analyses
• Ability to monitor and perform in-depth analysis of data for customers
• Ability to identify complex data problems and issues and is responsible for resolution
• Ability to identify complex trends and make recommendations to business areas
• Ability to communicate meaningful insights by creating charts and slide presentations
• Ability to maintain and coordinate existing cross-functional programs
• Ability to support and manage complex applications systems on many platforms
• Ability to develop, maintain, and monitor reports on system security
• Ability to ensure appropriate security and privacy for all data that contains PHI fields
• Ability to represent department on enterprise project teams and process optimization efforts
• Ability to serve as a mentor/coach for less experienced employees