Blue Cross NC is seeking a Senior Business Intelligence Analyst for their Medical Economics team, focusing on Payment Integrity analytics. The role involves advanced data analysis, stakeholder engagement, and the creation of actionable insights to improve claims accuracy and cost efficiency
Job Summary
Lead end‑to‑end analytical support for Payment Integrity programs, including pre‑pay and post‑pay claims reviews, coding intensity and DRG shift analysis, and E&M level distribution and complexity migration.
Develop and maintain dashboards, reports, and analytical models using claims, eligibility, provider, and benchmark data, performing trend analysis, benchmarking, and peer comparisons.
Translate analytical findings into clear, concise narratives for leadership, including Medical Economics, Finance, Network, and Clinical partners, and support executive‑level presentations.
Matching Summary
Match Score: 85
Blue Cross NC is seeking a Senior Business Intelligence Analyst for their Medical Economics team, focusing on Payment Integrity analytics. The role involves advanced data analysis, stakeholder engagement, and the creation of actionable insights to improve claims accuracy and cost efficiency.
Salary
Base: $98,092.00 - $156,947.00; Bonus/Equity: Annual Incentive Bonus*; Benefits: 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs
Skills & Requirements
Must-have
advanced analyses
cost leakage identification
medical and pharmacy claims
advanced proficiency in SQL
healthcare claims knowledge
BI and visualization tools
Nice-to-have
thought partner to leadership
validate vendor findings
Python or R for advanced analytics
Blue plan or large regional payer
Key Requirements
5+ years of experience in related field
7+ years of experience in related field (in lieu of degree)