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Capital Blue Cross · 1 week ago

Manager of Government Programs Performance Analytics

Harrisburg, PA

Full-time

Onsite

Mid, Senior Level, Lead/Staff

$99K/yr - $186K/yr

8+ years exp

Capital Blue Cross is committed to exceptional service for their team and community, consistently recognized as a top workplace in Pennsylvania. The role focuses on providing data-driven insights and financial planning for Medicare Advantage, ACA, and CHIP programs, ensuring performance optimization and regulatory alignment for senior leadership.

ConsultingHealth CareHealth InsuranceProfessional Services

Responsibilities

Support financial strategy, forecasting, and performance oversight for Medicare Advantage and ACA portfolio

Support financial planning cycles, including annual operating plans, forecasts, and long-range strategic planning for government program

Analyze medical cost trends, revenue drivers, and margin performance to inform executive decision-making

Act as a thought leader and financial advisor to internal department stakeholders

Direct the development of performance dashboards and executive scorecards for continuous monitoring and accountability

Support CMS and state regulatory filings

Serve as a subject matter expert on market dynamics and payer economics

Qualification

Financial modelingHealthcare regulations knowledgeData analysisExcel proficiencySQL proficiencyPower BI/TableauExecutive communicationActuarial skillsLeadership skillsStrategic thinking

Required

Exceptional strategic and analytical thinking with demonstrated ability to connect data and financial insights to enterprise-level strategy

Expert financial modeling and forecasting capability; strong actuarial skills, strong grasp of healthcare cost and revenue drivers

Excellent executive communication skills

Proven ability to drive complex initiatives in a matrixed organization

High proficiency in financial and data tools such as Excel, SQL, Power BI/Tableau, and statistical modeling platforms

Strong leadership skills

Proven ability to translate complex analytics into strategic action

Deep knowledge of Medicare Advantage and ACA regulations, bid and rating structures, payment methodologies, risk adjustment, STARS, and medical loss ratio (MLR) requirements

Strong understanding of CMS guidelines

Familiarity with clinical/utilization management and network strategies

8 years of progressive analytical experience in healthcare, financial management or related role

Bachelor's degree in finance, Actuarial Science, Economics, Health Administration, or related discipline