Senior Clinical Analytics & Policy Engineer (Remote)

bcbst; Chattanooga (TN); Remoto; USD 110.000 - 140.000; Tempo pieno

Descrizione del lavoro

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Sr. Clinical Business Analyst to advance medical policy operations using evidence-based methods, process improvements, and AI-enabled solutions. You will support policy development, regulatory alignment, and interoperability initiatives with cross-functional teams.

The role emphasizes literature surveillance, data analysis, and governance, with a focus on AI outputs validation and policy controls to sustain compliant clinical operations.

Competenze

• Bachelor’s degree or equivalent professional experience (4 years in healthcare/corporate).
• RN licensure in TN or compact state, or LMSW with TN license.
• 3 years in clinical operations or equivalent healthcare setting.
• 2 years in data analysis/reporting or performance improvement.
• 1 year in cross-functional project work; PM experience preferred.
• Experience with AI-enabled or advanced analytics and healthcare workflows.

Mansioni

• Analyze clinical, operational, and financial data to improve quality, utilization, access, and service delivery.
• Lead workflow analysis and implement evidence-based efficiency improvements.
• Translate clinical and business needs into actionable requirements with teams.
• Provide subject-matter expertise on clinical workflows and data interpretation.
• Ensure regulatory, accreditation, and governance standards compliance.
• Support evaluation and optimization of AI-enabled solutions and processes.
• Assess adoption, performance, and risks of technology implementations.
• Contribute to governance and controls for tech use in clinical settings.
• Collaborate with cross-functional partners to drive policy and operational changes.

Conoscenze

Analytical skills

Clinical analytics

Translate requirements into business

AI governance & ethics

Advanced Excel

Data reporting & analysis

Project management

Oral & written communication

Stakeholder collaboration

Formazione

Bachelor’s degree or equivalent (4 years healthcare/corp experience)

Strumenti

Microsoft Office suite

Descrizione del lavoro

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Sr. Clinical Business Analyst to advance medical policy operations using evidence-based methods, process improvements, and AI-enabled solutions. You will support policy development, regulatory alignment, and interoperability initiatives with cross-functional teams.

The role emphasizes literature surveillance, data analysis, and governance, with a focus on AI outputs validation and policy controls to sustain compliant clinical operations.