A Career of Your Calling

The Impact You Will Have
Blue Cross and Blue Shield of Minnesota is hiring a Principal Healthcare Analyst on our Risk Adjustment team in Eagan, MN.The Principal Healthcare Analyst – Risk Adjustmentis responsible forleading analyticalinsights todevelop and implement strategic business solutions through research, auditing, and data analysis. This roleleveragesdeepexpertiseinRiskAdjustment and healthcare data—primarily Medicare Advantage, Medicaid, and ACA Commercial—identifyingtrends and communicating insights to senior stakeholders across the enterprise.

The ideal candidate will have experience inRiskAdjustment methodologies, clinical coding, and healthcare programs (Medicare Advantage, Medicaid, ACA Commercial), as well asproficiencyin SQL, Power BI, and presenting findings to diverse audiences. Acting as a Content Expert and Business Lead, this position drives strategic initiatives and influences decision-making at Blue Cross Blue Shield of Minnesota.

Success in this role requires a combination of industry knowledge, programming and data skills, and strong statistical and analytical capabilities. The Principal Healthcare Analyst will make significant contributions that shape strategic decisions and improve organizational performance.

Your Responsibilities

• Usesdatabases for analysis and dissemination of information.

• Performs complex analysis of data.

• Researches, analyzes data, applies statistical methods whenappropriate, and provides interpretation of outcomes.

• Identifiesissues to be researched,determiningaffected areas, estimating theimpactand contributing to the resolution.

• Leads teams to develop analytic approaches, measurement plans, data analysis, and report results on health careutilization, 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 impactstocost 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.

• Representsthe 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 maybe responsible fortraining 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 inlayman's terms.

Required Skills and Experience

• 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

• 5years experienceanalyzing and modeling data involving outcomes andutilization, using various statistical software and computer programming (SQL and Power BI).

• Proficiencyin Microsoft software applications such as Word, PowerPoint, Excel, Access.

• Demonstrated ability to design,evaluateand 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 Skills and Experience

• At least3 to 5 years of experience workinginhealthcare analytics with a focus onRiskAdjustmentis 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,maintainand automate Power BI / SQL based dashboards and standard reports for leadership.

• Experience developing andmaintainingdashboards (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.