Healthcare Price & Transparency Analyst

Job not on LinkedIn

🔥 3 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🦅 H1B Visa Sponsor

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👻 Ghost score 12%

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Blue Cross and Blue Shield of Louisiana

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1934

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association, offering a range of health insurance products and services in the state of Louisiana. The company provides health, dental, and travel insurance options, including Medicare Advantage plans such as HMO and PPO. They focus on delivering comprehensive healthcare coverage through various plans to meet varying customer needs, while partnering with doctors, hospitals, and clinics to ensure quality care and support. Additionally, the company emphasizes wellness programs, cost-saving opportunities, and accessibility for its members.

📋 Description

• Perform pricing and transparency reporting functions to support compliance with Blue Cross Association and federal mandates • Provide members with cost information for common medical procedures, surgeries, treatments, and quality-of-care information • Support facility and professional reimbursement areas through implementation of processes, procedures, reports, software, and operational refinements • Collaborate with cross-divisional business areas, IT, and vendors to improve reimbursement operations and solve organizational information challenges • Build an efficient, effective, and compliant technical analytical reporting infrastructure • Refine, implement, automate, and manage the reimbursement operations strategy with senior team members and the Manager, Healthcare Price and Transparency • Design, configure, implement, maintain, and document transparency cost algorithms for internal and external transparency initiatives • Assess reimbursement operations, determine business requirements, identify improvement opportunities, and assist with business and technology systems design • Recommend business process improvements, system testing, controls, and protocols • Perform data transformation, data validation, reporting, and analytics

🎯 Requirements

• Bachelor's degree in a related field is required; four years of related experience may be used in lieu of a bachelor's degree • 2 years of analytical experience in healthcare, IT, finance and/or related industries required • Basic understanding of provider payment methodologies, complex provider contracts, medical coding, clinical editing, analytic-driven healthcare pricing transparency initiatives or equivalent experience preferred • Basic understanding of clinical and payment methodologies including per diems, APC, DRG, MPFS, CCI, etc. preferred • Extensive knowledge of SQL, including writing queries, importing data, and creating tables and views, in environments such as Microsoft SQL Server, Azure Databricks and/or Snowflake • Experience with analytics/visualization tools such as Tableau and Power BI required • Strong analytical and critical-thinking skills • Excellent oral and written communication skills, including the ability to present complex financial analysis and technical topics clearly to internal staff and external vendors • Extensive knowledge of Microsoft Office, including Excel and Pivot Tables, and PowerPoint • Ability to work proficiently in a fast-paced, demanding environment • Medical coding designation such as CPC or CPHC preferred • Must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support • Successful background and pre-employment drug screening required prior to hire

🏖️ Benefits

• Resources to live well and be healthy • Learning and professional development opportunities • Skills development and professional growth opportunities • Opportunities to serve local communities • Smoke- and tobacco-free company properties • Reasonable accommodation support for applicants with disabilities