Wellmark Blue Cross and Blue Shield · 1 month ago
Sr. Cost of Health Care Strategy Analyst
Des Moines, IA
Full-time
Hybrid
Senior Level
5+ years expWellmark Blue Cross and Blue Shield is a mutual insurance company focused on the well-being of its members. The Sr. Cost of Health Care Strategy Analyst will drive the company's value-based strategy by designing and implementing payment models, analyzing data, and providing actionable recommendations to improve health care outcomes.
Financial ServicesHealth InsuranceInsurancePersonal Health
No H1B
Responsibilities
Develop new value-based payment models and data analytics and reporting, using internal data sources and vendor relationships
Provide actionable data and recommendations to health care organizations as it relates to medical cost and quality. The Sr. Analyst will collaborate with the Network Payment Strategy and Network Performance teams and will meet with value-based health care organizations to review performance and drive action plans that achieve cost of care, quality and financial performance
Develop opportunity projections and determine the viability of various opportunities to support strategic decision making as it relates to cost of care, efficiency and quality to drive Wellmark’s value proposition with stakeholders
Support other Analysts by mentoring, coaching and providing guidance and industry expertise
Serve as a business liaison for Network Payment Strategy and Network Performance teams on strategic initiatives and projects
Extract, analyze, interpret, and integrate data using internal and external data sources to develop initiatives, support recommendations and draw conclusions to internal and external stakeholders to achieve business strategies and goals
Ensure data integrity by performing quality assurance checks for vendor reporting. Will collaborate with other analysts to conduct monthly verification of the vendor dashboards
Maintain collaborative relationships with internal and external stakeholders, including health care organizations and vendors, to communicate Wellmark’s value-based payment strategy and present utilization, financial and clinical information clearly and accurately
Support the Network Performance team in creating and maintaining relationships with provider groups by identifying, initiating and establishing appropriate internal and external contacts and sources needed for information sourcing
Support stakeholders in monitoring progress towards goals by demonstrating the comprehensive impact of recommendations (e.g., illustrate and explain results of return on investment and/or program evaluation analyses)
Support Network Payment Strategy and Network Performance initiatives by documenting and monitoring value-based health care organization payment initiatives
Perform routine analysis for Wellmark leadership to monitor payment methodologies for effectiveness. Apply qualitative and quantitative techniques to interpret provider payment data, identify opportunities and provide recommendations as appropriate
Other duties as assigned
Qualification
Required
Bachelor's degree or direct and applicable work experience
5+ years of experience: Pulling reports, analyzing, and interpreting complex data – e.g., clinical outcomes, claims data, utilization trends, etc. Ability to interpret and integrate data, or perform statistical analyses and data modeling techniques
Health insurance, health care, or related industry experience
Proficiency with Microsoft Office applications, including Excel. Ability to create or customize ad hoc reports and knowledge of formulas, vlookups, linking spreadsheets or data sources, data summarization/visualization, etc
Proficiency in SAS and SQL for data extraction, manipulation, and analysis and the technical aptitude to learn new data management and analysis tools or methodologies quickly
Strong consultation, relationship management, and critical thinking skills. Ability to develop business acumen and ask meaningful questions in order to effectively consult with and influence stakeholders
Strong written and verbal communication skills with the ability to communicate complex concepts to varied audiences. Ability to develop and deliver presentations
Attentive to details. Ability to collect, monitor, and assess the accuracy, validity, and integrity of data
Ability to educate stakeholders on complex, technical subjects
Experience coaching and mentoring others
Valid Driver's License with intermittent travel, less than 5%
Preferred
Experience developing executive summaries
Have a passion for mentorship and coaching
Familiarity with SAFe Agile Methodology
Company
Wellmark Blue Cross and Blue Shield
Wellmark Blue Cross and Blue Shield and its subsidiaries provide health coverage to more than 2 million members in Iowa and South Dakota.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
John Forsyth
Chief Executive Officer
Andrew Neller
Deputy Chief Information Security Officer
Recent News
2022-02-18
Company data provided by crunchbase