Blue Cross and Blue Shield of Louisiana Jobs

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Blue Cross and Blue Shield of Louisiana Senior Health Quality Management Program Analyst in Baton Rouge, Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Please note that effective Jan. 4, 2022, Blue Cross and Blue Shield of Louisiana implemented a policy requiring any employee who enters any of our offices or who interacts in person with anyone for company business purposes to be fully vaccinated for COVID 19, unless legally entitled to a reasonable accommodation related to religious or medical exemptions. At this time, that policy is suspended and vaccination is not required to enter our facilities. Please note this is subject to change at any point in time to ensure compliance with company policy or government mandates and certain client facing roles may have separate protocols.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

Plan, design, and manage projects to improve organizational performance related to the BCBSLA Quality Program. Specified operations include but may not be limited to the identification of clinical quality improvement opportunities; the design, implementation, and completion of clinical quality improvement projects and initiatives; and the analysis and reporting of clinical quality and cost data. The initiatives support the Organization’s strategic goals including the engagement of providers, provider performance measurement, the support of value-based programs, and the achievement of regulatory compliance and accreditation requirements related to clinical data analysis, quality improvement, and population health. Accountable for complying with all laws and regulations associated with duties and responsibilities.

NATURE AND SCOPE

  • This role does not manage people

  • This role reports to this job: MANAGER, HEALTH & QUALITY MANAGEMENT CLINICAL QUALITY MANAGEMENT

  • Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with the following: All levels of BCBSLA personnel including healthcare analytics, electronic data warehouse, care management and provider network staff; contracted vendors and if needed governmental and regulatory entities.

QUALIFICATIONS

Education

  • Bachelor's degree in business, analytics, engineering, public health, clinical or a related field is required.

  • Four years of related experience can be used in lieu of a Bachelor’s degree.

Work Experience

  • 4 years of experience assessing quality and performance improvement measures and/or analyzing clinical and healthcare claims data is required.

Skills and Abilities

  • Knowledge of Minitab for statistical testing and clinical research interpretation required.

  • Must have the ability to utilize Teradata for analyses, to critically evaluate data and effectively present information to multiple stakeholders for quality improvement efforts.

  • Requires the ability to effectively manage multiple projects from beginning to end.

Licenses and Certifications

  • Lean Six Sigma Black Belt required.

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

  • Responsible for working with teams and leadership to plan, design, and manage projects to improve organizational performance and achieve enterprise goals. Utilizes lean six sigma methodologies and change management skill to facilitate projects at least monthly.

  • Collaborates with the Manager, Health Quality Management Operations and Clinical Quality Improvement to contribute to the annual development, implementation, and evaluation of the Organization’s Quality Plan including the attainment of goals at least annually.

  • Provides technical, statistical, and analytical expertise and support to teams and individuals to enhance clinical operations, business operations, and service delivery, including but not limited to value based programs and preventive health initiatives using Teradata and/or Minitab daily.

  • Provides training, education and mentoring in performance improvement methodologies and analytics at least monthly.

  • In collaboration with Health Analytics and EIM, participates in departmental efforts to identify clinical quality and cost improvement opportunities through the analysis of data. Designs, uses and maintains clinical quality databases linked to the Enterprise Data Warehouse (EDW) at least monthly.

  • Provides analytics for vendor products used within the department to ensure compliance with agreed upon performance requirements. Identifies opportunities for improvement and collaborates with delegated entities to ensure full compliance daily.

  • Provides assistance and serves as back up analyst for HEDIS as needed.

Additional Accountabilities and Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

  • Perform other job-related duties as assigned, within your scope of responsibilities.

  • Job duties are performed in a normal and clean office environment with normal noise levels.

  • Work is predominately done while standing or sitting.

  • The ability to comprehend, document, calculate, visualize, and analyze are required.

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An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Insurance

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