Analyst QVBC

The Quality and Value Based Care area strives to develop a "best in class" service model and experience for our senior population. Our team works closely with other associates and business areas that support Medicare Advantage members in an effort to meet and exceed customer expectations and continue driving toward strategic improvement.

The Quality Management/Plan Performance Analyst will be responsible for supporting the quality improvement, risk adjustment and/or plan performance processes. This includes monitoring and reporting of quality, risk and/or performance indicators, identification of opportunities for improvement, conducting qualitative barrier analysis, collaborating with business areas to identify strategies for improvement and monitoring impact of initiatives. This position will monitor outcomes of key indicators including health status, health outcomes, member experience and operational metrics and understand regulatory requirements. The incumbent will work collaboratively with the internal team to support research and analysis, and incorporates policies and practices to ensure execution of a sound program to maintain integrity of internal procedures.

• Bachelor's Degree
• Minimum of 2 years of experience in areas such as the healthcare field, quality improvement strategies, regulations related to quality, project management, and/or methods for data analysis techniques and interpretation
• Experience with project management and continuous improvement, along with organizational and analytical skills in order to independently identify and evaluate opportunities for improvement related to Key Quality Indicators (KQIs)
• Experience providing support on complex project scopes and assist in the creation of work plans to achieve the objectives of projects
• Strong communication skills, both orally and written, along with positive collaboration and excellent interpersonal skills
• Experience handling day to day decisions with minimal guidance
• Experience working with management to determine priorities and planning that support direction of a division
• Proficient in Microsoft Word, Excel and PowerPoint
• Willingness to travel as required for training, collaboration and education purposes
• Experience presenting data or information for the purposes of proposal or decision making preferred
• Knowledge of quality improvement strategies and regulations preferred
• Knowledge of data analysis techniques and interpretation preferred
• Demonstrated experience analyzing or reporting data sets using tools such as WinSQL, Crystal Reports, Excel, and or Tableau strongly preferred
• Experience in a position leading large scale projects including project scope, budget, and resource planning, scheduling, tracking and reporting strongly preferred
• Experience using project management techniques and tools preferred
• Experience analyzing business processes and identifying solutions is ideal
• CPC/CRC Preferred
• Knowledge of Medical Coding understanding ICD -10, CPT and HCPCS coding systems preferred
• Experience analyzing medical records for proper ICD-10 documentation is preferred
• Demonstrated knowledge of Hierarchical Condition Categories (HCC) is preferred

The work location for this position will be hybrid (onsite/remote)

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Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association