Senior Medicare Programs Business Analyst (Job Number:8215)
Description
Summary:
This position is responsible for analysis, implementation, and process improvement activities in support of the Medicare Product Management team. This position will work with Product and Program Management staff and serve as a partner and liaison with internal and external stakeholders. Responsible for driving product-related process improvement and for providing leadership of cross-functional teams that include BCBSM business units and external partners This position performs analysis and research, prepares reports and analyzes trends to support Blue Cross/Blue Plus Medicare programs. Uses computerized systems (PC and/or mainframe) to create reports, graphs and charts of data developed. Develops organization business policies, template communications, conducts project management efforts and cooperates with other departments/organizations in the preparation of analyses. This position may also serve as a Government Programs representative on cross-functional workgroups.
Accountabilities:
1. Defines product requirements and perform business analysis on such topics as enrollment projections, pricing, and Medicare Part C and D reporting, bid preparation. Develops project plans and schedules. Facilitates process analysis and modeling, requirements analysis, workflow, and performance (productivity and quality) measurement. Assists in monitoring implementation and post-implementation follow-up activities.
2. Maintains regulatory product expertise with regard to both Medicare and State requirements and serves as resource and expert to internal and external organization.
3. Leads cross functional teams to drive business process improvement and analyze operational opportunities, and implement product changes to existing products.
4. Assists individuals and teams (both internal and external) in documenting, standardizing and sharing improvements across the organization.
5. Acts as a liaison with internal partners and external vendors to identify opportunities and needs and researches/develops implementation plans for meeting these needs.
6. Conducts in-depth research and analysis. Identifies trends and emerging issues and recommends best practices to ensure maximum performance.
7. Assists in developing appropriate standards such as work methods, performance measurements and resources to support initiatives.
8. Documents performance measurements and process changes.
9. May manage relationships with vendors.
Qualifications
Required Qualifications:
- Bachelors degree and 5 years of technical and business experience; or 9 years of technical and business experience in lieu of a degree.
- Experience with Medicare Parts A, B and D programs at state and federal level
- Experience working with Pharmacy Benefit Management for Medicare Part D
- Experience with health insurance regulations at state and federal level
- 4 years of experience populating databases, downloading, uploading and formatting data
- Proficiency with Microsoft Project, Visio, Excel and PowerPoint
- Strong verbal and written communication skills
Preferred Qualifications:
- Knowledge of health plan operations including claims, enrollment, sales, health services, membership, and marketing,
Blue Cross and Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action Employer, M/F/D/V. Blue Cross and Blue Shield of Minnesota is a drug free workplace. Candidates are required to pass a background check and drug test before beginning employment.
Primary Location: United States-Minnesota-Eagan
Description
Summary:
This position is responsible for analysis, implementation, and process improvement activities in support of the Medicare Product Management team. This position will work with Product and Program Management staff and serve as a partner and liaison with internal and external stakeholders. Responsible for driving product-related process improvement and for providing leadership of cross-functional teams that include BCBSM business units and external partners This position performs analysis and research, prepares reports and analyzes trends to support Blue Cross/Blue Plus Medicare programs. Uses computerized systems (PC and/or mainframe) to create reports, graphs and charts of data developed. Develops organization business policies, template communications, conducts project management efforts and cooperates with other departments/organizations in the preparation of analyses. This position may also serve as a Government Programs representative on cross-functional workgroups.
Accountabilities:
1. Defines product requirements and perform business analysis on such topics as enrollment projections, pricing, and Medicare Part C and D reporting, bid preparation. Develops project plans and schedules. Facilitates process analysis and modeling, requirements analysis, workflow, and performance (productivity and quality) measurement. Assists in monitoring implementation and post-implementation follow-up activities.
2. Maintains regulatory product expertise with regard to both Medicare and State requirements and serves as resource and expert to internal and external organization.
3. Leads cross functional teams to drive business process improvement and analyze operational opportunities, and implement product changes to existing products.
4. Assists individuals and teams (both internal and external) in documenting, standardizing and sharing improvements across the organization.
5. Acts as a liaison with internal partners and external vendors to identify opportunities and needs and researches/develops implementation plans for meeting these needs.
6. Conducts in-depth research and analysis. Identifies trends and emerging issues and recommends best practices to ensure maximum performance.
7. Assists in developing appropriate standards such as work methods, performance measurements and resources to support initiatives.
8. Documents performance measurements and process changes.
9. May manage relationships with vendors.
Qualifications
Required Qualifications:
- Bachelors degree and 5 years of technical and business experience; or 9 years of technical and business experience in lieu of a degree.
- Experience with Medicare Parts A, B and D programs at state and federal level
- Experience working with Pharmacy Benefit Management for Medicare Part D
- Experience with health insurance regulations at state and federal level
- 4 years of experience populating databases, downloading, uploading and formatting data
- Proficiency with Microsoft Project, Visio, Excel and PowerPoint
- Strong verbal and written communication skills
Preferred Qualifications:
- Knowledge of health plan operations including claims, enrollment, sales, health services, membership, and marketing,
Blue Cross and Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action Employer, M/F/D/V. Blue Cross and Blue Shield of Minnesota is a drug free workplace. Candidates are required to pass a background check and drug test before beginning employment.
Primary Location: United States-Minnesota-Eagan
