Analyst - Senior Medicare Advantage Enrollment Operations

Company: Blue Cross Blue Shield of Michigan Industry: Health Insurance and Health Care Level: Non-Manager JobFamily: Multi-divisional Compensation: Competitive Total Compensation Package About Us When you think of Blue Cross Blue Shield of Michigan for health insurance, you can know you’re getting much more. We’re a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future. We offer: Plans for employers and individuals that meet today’s needs, budgets and lifestyle The largest network of doctors and hospitals in the state Lower health care costs Higher quality health care Grants and programs that promote better health throughout Michigan Mission: We commit to being our members’ trusted partner by providing affordable, innovative products that improve their care and health. Overview Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers. Responsibilities Analysis Identify and analyze operational data and develop insights in support of business objectives. Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality. Identify and/or analyze business problems and develop recommendations for solutions to problems. Leadership Lead the development and implementation of projects and/or teams in order to produce desired results. Document and communicate project concepts, milestones and results. Recommend and assist with implementing standard policies and procedures. Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis. Teamwork Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide support to internal departments and external entities by answering questions, supplying information and training. Create and present reports and presentations to display operational data and proposed business changes. Requirements Bachelor's Degree in a related field is preferred. Four (4) years of experience in a related field is required. Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness. Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines. Excellent verbal, written communication and interpersonal skills. Ability to lead and contribute to business unit and/or corporate projects. Proficient in Microsoft Office Suites. Ability to develop and maintain effective working relationships. Departmental Preferences: Experience with CMS Enrollment and Disenrollment guidance is preferred. Experience with monthly/weekly Employer Group Membership reconciliation is preferred. Experience with monthly CMS membership reconciliation (MARx, TRR) is preferred. Ability to analyze discrepancies, manage large datasets and track resolution through internal reporting tools is preferred. Knowledge of CMS thresholds and compliance timelines for discrepancy resolution is preferred. Understanding of required documentation and timelines for retroactive processing and case development is preferred. All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability. #J-18808-Ljbffr Blue Cross Blue Shield of Michigan