Senior Clinical Business Analyst

Job not on LinkedIn

🔥 1 minute ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟠 Senior

🧐 Business Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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BlueCross BlueShield of Tennessee

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1952

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

BlueCross BlueShield of Tennessee is a leading health plan provider in Tennessee, serving 3. 4 million members. The company is committed to creating a workforce where everyone is valued, respected, and part of the team, emphasizing diversity and inclusion. They offer a range of career opportunities, including internships through their BlueBridge program, enabling new professionals to transition from college to work. BlueCross BlueShield of Tennessee also focuses on providing exceptional customer service and community care, striving to make a difference in the healthcare industry. It is an independent licensee of the Blue Cross Blue Shield Association and a qualified health plan issuer in the Health Insurance Marketplace.

📋 Description

• Support the Medical Policy Research & Development team by advancing medical policy operations through evidence-based practices, process improvement, and AI-enabled solutions • Drive the development and maintenance of medical policies through literature surveillance, regulatory and clinical guideline monitoring, and support for interoperability and healthcare digitization initiatives • Analyze clinical, operational, and financial data to identify opportunities to improve quality, utilization, access, and service delivery • Lead workflow and process analysis, recommending and implementing evidence-based improvements • Translate clinical and business needs into requirements and actionable insights with clinical, operations, IT, and analytics teams • Provide subject-matter expertise and education on clinical workflows, data interpretation, reporting, and system functionality • Ensure compliance with regulatory, accreditation, and internal governance standards • Support evaluation, implementation, and optimization of clinical and business processes, applications, and technology-enabled solutions • Assess, plan, and support responsible adoption of AI initiatives, including use case evaluation, requirements definition, and performance monitoring • Analyze adoption, performance, and outcome data for technology solutions • Contribute to policies, controls, and governance frameworks for technology use in clinical and operational environments

🎯 Requirements

• Bachelor’s Degree required, or equivalent professional experience • Equivalent experience defined as 4 years of professional work experience in a healthcare, clinical operations, or corporate environment • Registered Nurse (RN) with an active license in the state of Tennessee or a compact state OR Master’s-level Social Worker with an active Tennessee license (e.g., LMSW, LCSW) • 3 years of experience in clinical operations, care management, utilization management, population health, or a comparable healthcare setting • 2 years of experience in reporting, data analysis, business analysis, or performance improvement • 1 year of experience supporting projects, initiatives, or cross-functional workgroups • Demonstrated experience collaborating with clinical, operational, and technical partners to improve workflows, systems, or performance outcomes • Experience evaluating and supporting AI-enabled or advanced analytics solutions • Strong analytical, critical thinking, and problem-solving abilities • Ability to translate clinical and operational needs into clear business requirements • Strong judgment related to risk, bias, appropriateness, and governance considerations for analytics and AI-driven tools in clinical settings • Proficient in Microsoft Office (Outlook, Word, Excel, Access, PowerPoint) • Database reporting and data analysis experience • Ability to work independently and collaboratively within a team environment • Proven ability to manage multiple projects, priorities, and timelines • Excellent oral and written communication skills • Strong interpersonal, organizational, and time-management skills • Comfort operating in a fast-paced, evolving environment with emerging technologies and changing priorities • Demonstrated proficiency and comfort working with AI-enabled technologies and tools

🏖️ Benefits

• Remote work arrangement • Employee position • Equal employment opportunity and nondiscrimination protections