Senior Health Care Analyst - Clinical Data Strategy Lead

Responsible for planning, organizing, directing, implementation, and leading department assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget.

Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements. Within Clinical Data Strategy & Operations team, the position also provides strategic leadership for clinical data acquisition, exchange, interoperability, adoption, governance, and value realization.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

1. Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues.

2. Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.

3. Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.

4. Develop lines of communication to discuss/review results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions.

5. Investigate, review, recommend, communicate and implement solutions which identify problems/root cause of issues.

6. Identify and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities.

7. Independently develop strategies, plans, reports, papers, business cases, decision materials, and/or other materials in a clear and concise manner.

8. Provide expertise strategic guidance and analytic support to department and corporate staff as required.

9. Acts as liaison between corporate business areas and participates in workgroups, committees, governance forums, and cross-functional decision-making forums.

EDUCATION AND/OR EXPERIENCE

1. Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is required. Master's Degree in related field preferred.

2. Six (6) or more years experience in related experience, typically in two (2) subject areas (e.g. such as financial analysis, planning, health care economics, health care policy, statistical modeling, business decision support, data strategy, interoperability, health plan operations, or business management).

3. Experience developing strategies, roadmaps, business cases, recommendations, and executive presentations is preferred

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER SKILLS AND ABILITIES

1. Excellent analytical, strategic planning, problem solving, verbal and written, presentation and stakeholder-management skills to communicate complex ideas.

2. Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).

3. Strong working knowledge of data languages such as SAS or SQL.

4. Ability to work independently, within a team environment and communicate effectively with employees at all levels.

5. Knowledge of clinical data exchange, FHIR, APIs, healthcare data standards, interoperability workflows, data governance, HEDIS, digital quality, risk adjustment, care management, utilization management, or provider engagement is preferred for the departmental assignment.

6. Other related skills and/or abilities may be required to perform this job.

DEPARTMENTAL PREFERENCES

• Demonstrated experience developing or advancing clinical data strategies, roadmaps, priorities, and investment recommendations related to data acquisition, exchange, governance, standardization, interoperability, and enterprise use.
• Knowledge of healthcare industry trends, regulatory developments, interoperability capabilities, vendor solutions, and methods for assessing current-state gaps and future-state opportunities.
• Experience with EMR/EHR or HIE connectivity initiatives and solutions such as Epic Payer Platform, AthenaPayer, Healow Insights, Oracle Health, Veradigm, or comparable platforms.
• Experience supporting or leading complex, cross-functional clinical data or interoperability initiatives from planning through implementation and optimization.
• Experience establishing or supporting governance structures, business standards, decision frameworks, and accountability for data or interoperability initiatives.
• Demonstrated ability to facilitate alignment and influence decisions across business, technology, analytics, compliance, privacy, legal, provider engagement, operations, and vendor stakeholders.
• Strong executive communication and presentation skills, including communicating strategy, performance, risks, recommendations, and decisions to leadership and governance forums.
• Experience defining or monitoring business outcomes, adoption measures, data-quality indicators, and value metrics for clinical data, interoperability, or other enterprise initiatives.
• Ability to evaluate solution effectiveness and recommend enhancements that improve data availability, timeliness, completeness, usability, scalability, reuse, adoption, and operational effectiveness.
• Analytical and problem-solving skills necessary to connect clinical data capabilities to quality improvement, risk adjustment, provider engagement, care management, utilization management, digital quality, or other enterprise priorities.
• Experience supporting strategic relationships with EMR/EHR, HIE, data, or technology vendors and external partners.
• Ability to assess vendor capabilities, roadmaps, delivery performance, strategic fit, dependencies, and material risks, and to communicate findings through appropriate governance channels.

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.