• Job Description

  Req#: JR100039
  Pay Range:
  $73,500.00 - $110,300.00
  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.
  ESSENTIAL JOB FUNCTIONS :
  
  • Extract and analyze health care data for specific studies and corporate initiatives, lead and plan data intensive projects and department initiatives.
  • Serve as a technical resource and mentor to less experienced staff on data and programming issues.
  • 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.
  • Serve as departmental representative on various committees and at meetings with other departments on various projects and corporate initiatives. Represent the organization at external meetings.
  • 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.
  • 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.
  
  QUALIFICATIONS:
  Minimum Education and Experience:
  
  • Bachelor's degree in Computer Science, Mathematics, Economics or related field; or an equivalent combination of education and experience
  • Three to five years of health data analysis, business analysis, software application, database design, and technical documentation experience
  
  Preferred Education, Additional Qualifications and Experience:
  
  • Experience in the health insurance industry including HEDIS and STAR Rating
  
  Required Knowledge, Skills, and/or Abilities:
  
  • Knowledge of claims processing and membership processing for all BCBSRI lines of business
  • Knowledge of ICD, CPT, HCPCS and SNOMED codes
  • Strong foundation of Alteryx, SQL and/or Python programming, data visualization tools (PowerBI preferred) and database software (Snowflake)
  • Knowledge of general mathematical principals
  • Working knowledge of Microsoft Excel and Windows
  • Strategic and critical thinking skills
  • Strong analytical skills
  • Strong business acumen and political savvy
  • Strong negotiation skills
  • Strong written and verbal communication skills
  • Strong problem-solving skills
  • Ability to work effectively with a wide variety of people in individual and group settings
  • Strong organizing skills, with the ability to prioritize and respond to shifting deadlines
  • Strong time management skills
  • Ability to manage diverse and deadline-oriented workflow
  
  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.

• About the company

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