Healthcare Price & Transparency Analyst

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

Applicants must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support. Louisiana Blue will not provide current or future employment-based immigration sponsorship or other immigration support for this opportunity, including H-1B, L-1, O-1, H-1B1, E-3, TN, or J-1 sponsorship or F-1 OPT/STEM OPT/CPT support. Applicants who would require such sponsorship or employer support during their employment should not pursue this opportunity.

Performs pricing and transparency reporting functions to ensure adherence to Blue Cross Association and federal mandates to provide members with the cost of common medical procedures, surgeries, treatments, etc. as well as quality of care information. Supports facility and professional reimbursement areas through implementation of new processes, procedures, reports, software and the refinement of existing operations. Collaborates with multiple cross-divisional business areas and vendors to improve reimbursement operations, solve organizational information challenges and build an efficient, effective and compliant technical analytical reporting infrastructure.

• This role does not manage people
• This role reports to this job:
  Manager, Healthcare Price and Transparency
• Necessary Contacts:
  In order to effectively fulfill this position, the incumbent must be in contact with:
  
  Network Administration Management, IT Management, Benefits Administration Management, Medical Management, Medical Coding, Payment Integrity, Business Engineering Team, Project Management Office, Blue Cross Association, other health plans and software vendors in order to successfully configure and implement new and innovative payment programs that support Healthcare Reform.

• Bachelor's degree in a related field, preferably in health care administration, statistics, economics, mathematics, analytics, computer science, finance, accounting business or related quantitative or health care field is required.
• Master's degree such as MBA, MPH, MS or MA preferred
• Four years of related experience can be used in lieu of a Bachelor’s degree.

• 2 years of analytical experience in healthcare, IT, finance and/or other 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 is preferred.
• Basic understanding of clinical and payment methodologies including per diems, APC, DRG, MPFS, CCI, etc. is preferred.

• Must have extensive knowledge of SQL including writing queries, importing data, and creating tables and views. This includes environments such as Microsoft SQL Server, Azure Databricks and/or Snowflake.
• Experience with analytic/visualization tools such as Tableau, Power BI, etc. is required.
• Strong analytical and critical thinking skills are required.
• Requires excellent oral and written communication skills including the demonstrated ability to present complex financial analysis and technical topics to all levels of internal staff and external vendors in a clear and understandable manner.
• Extensive knowledge of Microsoft Office products including Excel (including Pivot Tables) and Power Point is required.
• Requires the ability to work proficiently in a fast-paced, demanding environment.

• Medical coding designation such as CPC or CPHC is preferred.

• Works closely with senior team members and the Manager, Healthcare Price and Transparency to continually refine, implement, automate, and manage the reimbursement operations strategy, focusing on the efficient, compliant and cost-effective use of existing software and applications.
• Collaborates with vendors, IT and multiple cross-divisional business areas to improve reimbursement operations, solve organizational information challenges and build an efficient, effective and compliant technical analytic reporting infrastructure.
• Supports the design, configuration, implementation, maintenance and documentation of transparency cost algorithms for internal and external…