Louisiana Blue · 5 hours ago
Senior Healthcare Innovations Analyst
United States
Full-time
Remote
Mid, Senior Level
4+ years expLouisiana Blue is committed to improving the health and lives of Louisianians by providing resources for employees to thrive. The Senior Healthcare Innovations Analyst will be responsible for managing quality management initiatives, collaborating with various stakeholders to ensure accreditation and achieve strategic goals.
Health CareInsuranceNon Profit
Responsibilities
Coordination with Health Informatics; Population Health; FEP: MTM pharmacists; and other applicable areas with focus on quality improvement (FEP, HEDIS, CAHPS, etc.). Analyzes validity of QM data/reports from a clinical perspective
Support URAC accreditation activities and Quality improvement activities ensuring on-going accreditation for the Organization
Performs accurate concurrent and retrospective review, as needed to support performance improvement activities in conjunction with the goals and strategic plan. Assists in performance measurement activities for both providers and the organization (HEDIS, CAHPS and performance measures) at the Plan level, the state level, the BCBS Association level and/or other national initiatives adopted by the Organization to achieve strategic goals
Utilizes systematic data collection, aggregation, analysis and reporting techniques to achieve concurrent compliance review of identified quality/patient safety metrics
Assists the Manager and Department Director and collaborates with the Healthcare Innovations team and analysts to compile reports for internal and external consumption. Helps quality improvement (QI) manager to plan, design, implement, and maintain quality improvement program(s)
Assists in internal (BCBSLA employees) and external (membership, community, etc) wellness activities to promote prevention and positive health outcomes of our employees and members. This includes but is not limited to Health Fairs and Gaps in Care programs
Works with all areas of the company to assist in the implementation and expansion of pay for performance programs, which includes but is not limited to network management, provider quality performance and payment methodologies that support the Plan’s corporate goals and maximizes the Plan’s competitive position
Works with Reimbursement and Network Management departments to support quality measurement goals and provider negotiated contracts with the goal of maintaining a high level of provider satisfaction and impact total cost of care
Maintain access to applicable data portals and support review of performance data to identify quality improvement opportunities
Serve as representative on organizational committees, work groups, and special projects that impact activities and functions internally and externally assisting in the design of business solutions and achievement of corporate goals. Responsible for Organizational service and clinical committees required to meet regulatory guidelines
Reporting on opportunities identified and improvement initiatives proposed or in progress. Provide reports comparing progress with national and/or other benchmarks. May require additional research into quality standards and practices
Pursuit of Lean Six Sigma Green Belt and/or training for Healthcare Quality certification (CPHQ, CPC)
Accountable for complying with all laws and regulations and accreditation standards associated with assigned duties and responsibilities
Perform other job-related duties as assigned, within your scope of responsibilities
Qualification
Required
Bachelor's in nursing or business related field is required
In lieu of Bachelor's degree an RN license can be used
In lieu of Bachelor's degree four years of related experience in healthcare quality can be used
4 years of professional nursing practice to include two years of experience in healthcare insurance and/or experience in health care quality required
Prior experience in organizational assessment (audit) and coordinating efforts to gather data and prepare reports to meet requirements (URAC, NCQA and other regulatory/accrediting agencies) required
Strong analytical, research, documentation and report skills and ability to analyze QI data and identify trends and corrective actions required
Excellent oral and written communication, report preparation, and presentation skills to both peer and upper-level management required
Proficient at utilizing computer programs to effectively collect, analyze, present, and communicate data to the various internal and external stakeholders required
Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure Registered Nurse licensed to practice in the State of Louisiana required
Preferred
Residency in or relocation to Louisiana is preferred for all positions
Strongly prefer quality management processes; research, interpretation and/or analysis experience
Experience working with predictive models and Healthcare Quality metrics (e.g. HEDIS) preferred
Experience with interacting effectively with health care team members preferred
Working knowledge of relevant BCBSLA software systems preferred
Lean Six Sigma Green Belt Certification or higher level certification preferred
Quality certification (CPHQ, CPC) preferred
Benefits
Health Fairs and Gaps in Care programs
Lean Six Sigma Green Belt and/or training for Healthcare Quality certification (CPHQ, CPC)
Company
Louisiana Blue
Louisiana Blue is a company on a mission: to improve the health and lives of Louisianians.
1001-5000 employees
H1B Sponsorship
Louisiana Blue 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 (7)
2024 (5)
2023 (11)
2022 (9)
2021 (9)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Crystal Blanchard
Account Executive
Recent News
New Orleans CityBusiness
2025-09-19
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