Provides data analysis, data profiling, and reporting support to various FEP Information Management initiatives associated with the Data Warehousing, Business Intelligence, and Member Incentive platforms. This includes projects for enhancing these platforms as well as operational support activities. Provides business rules associated with data manipulation and data transformations. Identifies reporting needs and develop reports for business operations metrics. Requires a solid knowledge and understanding of business, operations and/or technical components of a health insurance organization. Serve as business owner of data sourced, developed, transformed and consumed downstream from data warehouse.
Responsibilities include but are not limited to:
- Conduct data analysis and data profiling to determine the operational and IT impacts of assigned projects and/or initiatives, such as data governance. Based on the in-depth understanding of the existing data within the data warehousing platforms as well as the existing or new business processes, provide business rules for data transformation and data manipulation.
- Develop in-depth understanding of various business processes and associated data needs. Identify opportunities for enhancing business value through use of data. Performs analysis of data including medical claims, pharmacy claims, member enrollment/eligibility, and economic information to develop an integrated analytical foundation and data repository. Develop and implement processes to enhance data management practices associated with reference data, meta data and master data.
- Identify data quality issues and work with the business and IT stakeholders to address these issues. Prioritize data quality issues and initiatives. Work with EIT to implement framework for identifying, analyzing, measuring and resolving data quality issues. Coordinate business and technical interests to define and agree on business goals and metrics, resolution and schedule for data quality initiatives. Establish standards and policies for proactively addressing data quality issues. Establish a central point for tracking identified issues. Monitor progress against data quality plans and communicate to stakeholders. Review and approve data quality deliverables. Manage metadata review and update process. Promote an enterprise point of view for data usage.
- Identify reporting / dashboard needs based on business operations metrics as well as management reporting. Work with appropriate IT stakeholders to develop and distribute reports.
- Create artifacts and deliverables based on the appropriate audience. These can include reports, articles, PowerPoints, Excel documents, and/or position papers. This will require timely creation, editing, and seeking appropriate approvals to meet deadlines and specifications.
- Identify and recommend operational improvements to ensure efficiency across all lines of business. Performs required and appropriate monitoring, analysis and reporting of data environment to ensure performance and dimensions of data support the FEP strategy. Analysis includes an evaluation of business, clinical, and economic data. Provide reports on and graphical representations of data warehouse and repository environments. Collaborates with EIT and other stakeholders to ensure data environment is robust, reliable, complete, and accurate.
- Understands the technical aspects of solutions, business systems, and software which includes data warehouse-based applications, and reporting tools.
- Maintains a comprehensive understanding of the FEP business processes and how FEP Information Management platforms can support these functions.
- Provides oversight and guidance in the resolution of complex issues utilizing available resources and expertise in support of FEP strategic initiatives and mission critical projects.
Required Basic Qualifications:
- Bachelor's Degree in related discipline or equivalent work experience within a similar environment
- Minimum of 8 years' experience in operations or IT
- Minimum of 5 years' experience working in data warehousing and data analytics environment
- Experience in implementing cost-effective relational databases, data repositories/warehouses and business information systems
- 3-5 years related experience in the health insurance industry
- Experience in multi-tasking environment with ability to effectively assist and/or manage multiple projects concurrently; with the ability to function in a team-oriented, cross functional/matrixed environment
- Knowledge of data infrastructure, information systems, data analytics
- Knowledge and experience using data query and data manipulation tools
- Knowledge of and experience working with large data repositories and/or relational databases, performing advance business analysis and data mining
- Knowledge of SQL and should be familiar with other data/analytic tools such as Cognos, Tableau
- Knowledge and experience using Microsoft Office suite - Excel, Word, Visio and PowerPoint
- Advanced analytic skills with the ability to analyze and interpret data through complex analysis
- Ability to present information to mid to upper level management
- Ability to generate creative problem-solving/alternative approaches to existingprocesses/procedures
- Verbal, written and interpersonal communication skills
- Analytic skills with the ability to analyze and interpret data
- Relationship-building skills
- Self-starter with the ability to motivate others
- Inter-personal, organizational and decision-making skills
- Organization, prioritization and time management skills
- Written and oral communication skills (must be proactive with communication across and within teams and managing up)
- Ability to work with problem solving skills including identifying mitigation steps and making recommendations for improvements, as well as a track record for consensus building/influencing others and negotiating formally and informally with others
- Serve as change agent to improve efficiency and effectiveness in performing job duties
- Process oriented with ability to navigate through all stages of ideation
Prederred Basic Qualifications:
- Graduate degree in information systems, healthcare administration or other relevant concentration
- BCBSA or Blues System experience
Equal Opportunity Employer
Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics