Blue Cross and Blue Shield of Minnesota · 3 weeks ago
Principal Risk Adjustment Healthcare Analyst
Eagan, MN
Full-time
Hybrid
Senior Level, Lead/Staff
$100K/yr - $170K/yr
7+ years expBlue Cross and Blue Shield of Minnesota is dedicated to transforming healthcare and is seeking a Principal Risk Adjustment Healthcare Analyst. This role is responsible for leading analytical insights to develop and implement strategic business solutions through research, auditing, and data analysis, primarily focusing on Medicare Advantage, Medicaid, and ACA Commercial data.
Insurance
Responsibilities
Uses databases for analysis and dissemination of information
Performs complex analysis of data
Researches, analyzes data, applies statistical methods when appropriate, and provides interpretation of outcomes
Identifies issues to be researched, determining affected areas, estimating the impact and contributing to the resolution
Leads teams to develop analytic approaches, measurement plans, data analysis, and report results on health care utilization, expenditures, outcomes, and benchmarks
Initiates actions to discover new analyses that will contribute to the strategic needs of Blue Cross Blue Shield of Minnesota
Works with leadership to understand and interpret the impacts to cost and quality of proposals using relevant data sources and analytic methods
Helps drive the implementation of new products and systems by providing actionable information and recommendations that evaluate the impact of the proposed products and systems
Represents the division on corporate projects and may have leadership roles on these teams
Independently manages issues that may arise on multiple tasks or projects with limited or no management involvement
Acts as a resource and/or mentor for other members of the department and company on business issues and may be responsible for training and guidance of other employees
Formulates strategic recommendations and present findings to management and external clients
Serves as an analytic consultant who can explain complex measurement or analysis techniques and results in layman's terms
Qualification
Required
7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered
5 years experience analyzing and modeling data involving outcomes and utilization, using various statistical software and computer programming (SQL and Power BI)
Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access
Demonstrated ability to design, evaluate and interpret complex data sets
Demonstrated ability to handle multiple tasks with competing priorities
Demonstrated analytic and problems solving skills
Excellent written and verbal communication skills, with the ability to interpret and communicate analytical information to both individuals and groups in a clear and concise manner
Demonstrated ability to present complex technical information to non-technical audiences and to senior decision-makers
Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical and/clinical
High school diploma (or equivalency) and legal authorization to work in the U.S
Preferred
At least 3 to 5 years of experience working in healthcare analytics with a focus on Risk Adjustment is strongly preferred
Experience supporting multiple payers or lines of business (Medicare Advantage, Medicaid, ACA Commercial)
Familiarity with clinical coding (ICD-10-CM) and revenue cycles
Design, maintain and automate Power BI / SQL based dashboards and standard reports for leadership
Experience developing and maintaining dashboards (via Power BI) showing risk adjustment activities performance across multiple lines of business
Provide ad-hoc analysis to support business cases, audit responses, and reporting
Knowledge of managed care and healthcare claims preferred
Bachelor's degree
Benefits
Medical, dental, and vision insurance
Life insurance
401k
Paid Time Off (PTO)
Volunteer Paid Time Off (VPTO)
And more
Company
Blue Cross and Blue Shield of Minnesota
About Blue Cross Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Minnesota has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (4)
2023 (6)
2022 (2)
2021 (3)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Carrie S. Lawrence
Executive Administrator to the President & CEO and Chief of Staff
Patsy Riley
Chief Goverment Officer and Senior Vice President and CEO, ClearStone Solutions
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