Capital Blue Cross
Healthcare Insurance • Finance • B2C
Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.
Manager – Government Programs Performance Analytics
Job not on LinkedIn
October 16
🔔 Pennsylvania – Remote
💵 $98.9k - $186.3k / year
⏰ Full Time
🟠 Senior
🔴 Lead
👔 Manager
🦅 H1B Visa Sponsor
Capital Blue Cross
Healthcare Insurance • Finance • B2C
Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.
📋 Description
• Support financial strategy, forecasting, and performance oversight for Medicare Advantage and ACA portfolios • Support financial planning cycles, including annual operating plans, forecasts, and long-range strategic planning for government programs • Analyze medical cost trends, revenue drivers, and margin performance to inform executive decision-making • Act as a thought leader and financial advisor to internal department stakeholders • Direct the development of performance dashboards and executive scorecards for continuous monitoring and accountability • Support CMS and state regulatory filings • Serve as a subject matter expert on market dynamics and payer economics
🎯 Requirements
• 8 years of progressive analytical experience in healthcare, financial management or related roles • Prior experience in a payer environment is strongly preferred • Exceptional strategic and analytical thinking with demonstrated ability to connect data and financial insights to enterprise-level strategy • Expert financial modeling and forecasting capability; strong actuarial skills, strong grasp of healthcare cost and revenue drivers • Excellent executive communication skills • Proven ability to drive complex initiatives in a matrixed organization • High proficiency in financial and data tools such as Excel, SQL, Power BI/Tableau, and statistical modeling platforms • Strong leadership skills • Proven ability to translate complex analytics into strategic action • Deep knowledge of Medicare Advantage and ACA regulations, bid and rating structures, payment methodologies, risk adjustment, STARS, and medical loss ratio (MLR) requirements • Strong understanding of CMS guidelines • Familiarity with clinical/utilization management and network strategies • Bachelor’s degree in finance, Actuarial Science, Economics, Health Administration, or related discipline required • Advanced degree (MBA, MPH) or professional certification (FSA, ASA, CFA) strongly preferred.
🏖️ Benefits
• Medical, Dental & Vision coverage • Retirement Plan • Generous time off including Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • Professional development opportunities
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