Sr Manager, Analytics for Value Based Care and HEDIS - Hybrid

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week

Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week

Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month

Onsite: daily onsite requirement based on the essential functions of the job

Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This People Leader position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

Manages the day-to-day activities of the Analytics & Data Science department. Serves as the primary contact and resource for staff. Provides oversight, direction, development, problem resolution and leadership for the Analytics & Data Science Team. The team’s responsibilities include: transforming data into meaningful and actionable information for various customer segments; performing strategic data analysis to support medical management programs, quality and value-based partnerships, and a strategic and predictable corporate provider reimbursement strategy; establishing measurement standards; and identifying previously unknown relationships among the data for analyses of trends and healthcare issues.

REQUIRED QUALIFICATIONS

Required Work Experience

• •3 years of experience in data science, data analytics & reporting or scientific analysis (Sprvsr grades 31-33)
• •1 year of experience in supervisory/management field and/or project management experience (Sprvsr grades 31-33)

• •5 years of experience in data science, data analytics & reporting or scientific analysis (Mgr grades 34-35)
• •3 years of experience in supervisory/management role (Mgr grades 34-35)

• •10 years of experience in data science, data analytics & reporting or scientific analysis (Sr Mgr grade 36)
• •7 years of experience in management role (Sr Mgr grade 36)

Required Education

Bachelor's Degree in business, mathematics, statistics, healthcare administration or related field of study (All Levels)

Required Licenses

N/A

Required Certifications

N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

• •3 years of experience in management/leadership role (Sprvsr)
• •5 years of experience in management/leadership role (Mgr)
• •10 years of experience in management/leadership role (Sr Mgr)

• •1 years of experience in insurance or healthcare field (Sprvsr)
• •3 years of experience in insurance or healthcare field (Mgr)
• •7 years of experience in insurance or healthcare field (Sr Mgr)

Preferred Education

Master’s Degree in business, mathematics, computer science, or related field of study (All Levels)

Preferred Licenses

N/A

Preferred Certifications

SAS Certification, Tableau Certification, or Associate, Society of Actuaries (ASA)

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

• •Manage the day-to-day operations of the department.
• •Administer, interpret and maintain current working knowledge of the required BCBSAZ systems, procedures, forms and manuals as related to the assigned area of responsibly.
• •Review, update and maintain accuracy of department documentation, computer files, policies and procedures related to the department goals and objectives. Keep staff informed of new or updated standards, systems, procedures, forms and manuals through staff meetings and verbal and written communications.
• •Direct, evaluate, define and improve the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within department guidelines.
• •Provide guidance, motivation and encouragement to staff, conduct performance evaluations, identify and coordinate training needs, and evaluate and make recommendations in regard to employment decisions.
• •Consult and coordinate with various internal departments, external Blue Plans or business partners and government agencies.
• •Identify/Create the appropriate technical solutions / and address business issues.
• •Monitor external economic and healthcare issues affecting trends, preparing succinct, easy to understand presentations of results and conclusions.
• •Serve as an internal consultant to help define analytic needs and to help end users interpret and apply analytic results.
• •Explore relevant data sources to understand what metrics can potentially be produced. Prepare succinct, easy to understand presentations of results and conclusions.
• •Analyze, interpret and communicate information and present results in formats that facilitate decisions and actions. Aid in the development of new performance measurement tools and approaches and maintain up-to-date knowledge of emerging measurement standards.
• •Evaluate analytical findings to ensure accurate interpretation of data and development of meaningful data mining results.
• •Research latest developments by governmental and national entities (e.g. CMS, NCQA, AHRQ, Leapfrog, etc.) on the establishment of metrics to monitor and/or define provider quality information for the general public. Present findings and recommendations in written and verbal formats.
• •Lead the team in analyzing and mining multiple data sources to select statistically valid data samples; building, testing and implementing statistical models by investigating appropriate methods and algorithms. Effectively summarize and present findings to Executive Leadership that drive business decisions.
• •Design custom dashboards for various areas in the company. Research and define key metrics and data sources. Monitor for continued effectiveness and opportunities.
• •Identify/Create business tools and analytical solutions to address business issues.
• •The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
• •Perform all other duties as assigned.

REQUIRED COMPETENCIES

Required Job Skills

• •Intermediate PC proficiency
• •Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones.
• •Basic skill in word processing and presentation software
• •Intermediate proficiency in database, spreadsheet, statistical analysis, query / data mining, and business intelligence software
• •Advanced skill in project management
• •Advanced skill in mathematics and statistics
• •Working knowledge of classification tools (ICD, DRGs, ACGs, ETGs, etc.)

Required Professional Competencies

• •Maintain confidentiality and privacy
• •Communicate professionally to both internal and external customers
• •Analytical skills in observing and documenting processes at a detailed level
• •Proficiency in process improvement and business process design
• •Analyze and resea