Senior Analyst - MA Oversight, Project & Audit
Company: Blue Cross Blue Shield of Michigan
Posted on: February 16, 2020
DescriptionResponsible for leading the development and
implementation of programs and strategies by identifying insights
that enhance business decision making capability. This includes
developing or changing workflows and implementing process
improvements to enhance organizational products, programs and
service to our customers.
- Identify and analyze operational data and develop insights in
support of business objectives.
- Develop and improve work flows and business processes within
defined areas to improve customer service, decrease operational
costs and improve overall quality.
- Identify and/or analyze business problems and develop
recommendations for solutions to problems.
- Lead the development and implementation of projects and/or
teams in order to produce desired results.
- Document and communicate project concepts, milestones and
- Recommend and assist with implementing standard policies and
- Ensure that corporate compliance is communicated, implemented
and monitored on an ongoing basis.
- Participate in systems testing, develop procedures/controls and
provide recommendations for the ongoing improvement of the updated
- Provide support to internal departments and external entities
by answering questions, supplying information and training.
- Create and present reports and presentations to display
operational data and proposed business changes.Qualifications
- Bachelor's Degree in a related field is preferred.
- Four (4) years of experience in a related field is
- Excellent analytical and problem-solving skills to identify,
evaluate, recommend and implement changes to processes or
procedures to address problems and improve departmental
- Organizational skills and ability to prioritize; must be able
to lead multiple activities with varying timelines.
- Excellent verbal, written communication and interpersonal
- Ability to lead and contribute to business unit and/or
- Proficient in Microsoft Office Suites.
- Ability to develop and maintain effective working
- 5-10 years of medical claims experience (UB and 1500 claims)
- Experience with Medicare (CMS) claims processing guidelines, MA
PPO Benefits, and audit tasks.
- Experience with IkaSystems, PORTICO, and MediRegs.
- Some familiarity with claims processing system adjudication
- Excellent record keeping, documentation, communication, and
organization skills needed.
- Comfortable presenting information to leadership personnel and
- Proficient with Microsoft Office products (Word, Excel,
PowerPoint.)All qualified applicants will receive consideration for
employment without regard to, among other grounds, race, color,
religion, sex, national origin, sexual orientation, age, gender
identity, protected veteran status or status as an individual with
a disability.Job: OperationsPrimary Location: DetroitOrganization:
Claims, Enrollment & Prog Mgt-7108Schedule: Full-timeReq ID:
Keywords: Blue Cross Blue Shield of Michigan, Detroit , Senior Analyst - MA Oversight, Project & Audit, Accounting, Auditing , Detroit, Michigan
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