Manager, Network Analytics

Washington, DC, United States

Manages development, execution and maintenance of multiple national-scale Network Solution programs focused on, but not limited to, the Blue Distinction Centers specialty care programs, Value Based Care programs and Blue High Performance Network. Develops analytic approaches and aligns with multiple project teams including BHI. Uses both clinical and administrative data sources to evaluate program performance, selection criteria, extracts and analyzes data, and conducts rigorous analyses and appraisals to make recommendations and presentations for various internal and external audiences, including Senior Leadership, Plans and external audiences. Collaborates with internal and external teams to accomplish project goals. Builds and supports a strong team and maintains valuable business relationships in a cross-functional, fast- paced environment. General responsibilities include serve as a leader and consultant representing Network Solutions programs and initiatives across BCBSA , Commercial Markets, Plans and externally. This leadership role will keep current on department, division, Association, and industry trends/requirements to assure Network Solutions projects are developed and implemented in alignment with BCBSA infrastructure and policy; as well as, with consideration of industry and market expectations. Project responsibilities include analytics planning, Complex analytics using statistical methods, reporting and expressing data for providers, plans and other internal and external audiences.a) Manages all aspects of Network Solutions analytics including but not limited to Blue Distinction Centers (Centers of Excellence) programs, value based care programs, Blue High Performance network and other national network programs as may be developed. b) Interacts with BCBSA and Plan staff to support development of business perspectives on operational and clinical issues. Utilizes these interactions to build relationships and develop a network of business resources. Collects and analyzes data on health care markets, competitors and health plan performance; manages design and completion of project analyses in order to provide recommendations. c) Assists in the formulation, planning, monitoring and completion of cross-functional program research initiatives.

Transforms strategy into implementation of national network programs. Manages data and analytics across all Network Solutions program initiatives. The scope includes: a) Management of clinical data initiatives and ensures the accuracy of data and analytics; b) Supports, leads and conducts complex statistical and methodological appraisal and summaries; c) Performing analysis and synthesis of complex data; d) Making recommendations based on data analysis and synthesis and presenting to senior leadership, plans and external audiences as appropriate

Leads the outreach and collaborative engagement across diverse stakeholders (internal, Plan, and external) to develop, scope, and execute the delivery of all Network Solution initiatives

Leads a team of consultants and analysts as a supervisor and coach. Executes evaluations for direct reports as advised by BCBSA HR department. Education

Bachelors Degree

Masters Degree

Requires Bachelor's degree in Data Science / Analytics/ Computer Science

Advanced Degree in Analytics or Healthcare or Healthcare Administration, MBA, MPH

Certifications

Project Management Professional (PMP)

PAHM or FAHM certification through the Academy of Healthcare Management (or other demonstrated knowledge of healthcare industry.

Experience

5-7+ years of business analytics experience with at least 2 years in healthcare or similar industry in qualitative and quantitative analysis, data collection and synthesis

3+ years of supervisory experience and project management experience implementing complex projects and demonstrated leadership skills to drive projects to successful conclusion

3+ years of hands-on expertise in SQL/ Python/ Tableau

Skills

Excellent oral and written communication skills to effectively communicate to varying audiences internal and external to BCBSA using various media platforms

Strong analytical, organizational, processes and systems, and problem solving skills with the ability to conduct quantitative and qualitative analysis of health care concept.

Relationship management skills: builds and maintains strong business relationships;

Organizational skills; demonstrated ability to manage tasks, resources and identify process improvements in a fast paced environment;

Demonstrated leadership skills as well as supervisory skills

Hands-on expertise in SQL/ Python/ Tableau

Advanced skills using statistical packages such as SAS, R, or SPSS.

Demonstrated ability to manage multiple projects with overlapping timetables.

Customer relationship skills; ability to gain the confidence of customers through achievement of business objectives

Ability to influence others and to drive timely decision making.

Experience with performance based quality measures in the evaluation of hospitals, physicians, or other healthcare providers

Experience with or understanding of claims evaluation (e.g. coding, groupers, claims adjustment)

Experience in leading collaboration with clinicians, other team members and business partners.

Demonstrated leadership ability to identify data required to solve a given problem, organize data and identify major findings, lead development and testing of hypotheses, and develop creative, innovative resolutions.

People Management

Yes

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