Senior Healthcare Economics & Reimbursement Analyst

Wellmark Blue Cross and Blue Shield; Des Moines (IA); Hybride; USD 100 000 - 140 000; Plein temps

Résumé du poste

Wellmark Blue Cross Blue Shield in Des Moines, IA is seeking a Sr Network Economics Analyst to lead, design, implement and maintain provider reimbursement strategies and related financial reporting for contracted providers. You will mentor teammates and advise leadership on policy decisions.

As a senior member you will collaborate with Health Network stakeholders to enhance Wellmark's payment policies, while applying your data analysis expertise to drive continuous improvement and strategic

Qualifications

• Bachelor's degree in accounting/finance/business/economics or related field, or equivalent work experience.
• 7+ years in health insurance/healthcare with financial analysis and data modeling.
• Strong Excel skills plus Power BI/Tableau/SAS EG/SQL proficiency.
• Knowledge of provider payment, contracting strategies and reimbursement.
• Experience interpreting claims data and provider utilization for pricing strategy.
• Ability to mentor peers and present recommendations to leadership.

Responsabilités

• Lead, design, implement and maintain provider reimbursement strategies and related financial reporting.
• Perform advanced data analysis and generate insights to support reimbursement initiatives.
• Consult with stakeholders on payment strategy and policy decisions.
• Collaborate with Network Engagement to provide reimbursement guidance and policies.
• Configure and monitor data in provider payment systems; support testing and implementations.
• Manage service levels with provider payment vendors; perform other duties as assigned.

Connaissances

Advanced data analysis

Provider reimbursement

Contracting knowledge

Mentoring

Communication skills

Problem solving

Strategic thinking

Formation

Bachelor's degree in accounting, finance, business, economics or related field

Outils

Power BI

Tableau

SAS EG

SQL

Excel

Description du poste

Wellmark Blue Cross Blue Shield in Des Moines, IA is seeking a Sr Network Economics Analyst to lead, design, implement and maintain provider reimbursement strategies and related financial reporting for contracted providers. You will mentor teammates and advise leadership on policy decisions.

As a senior member you will collaborate with Health Network stakeholders to enhance Wellmark's payment policies, while applying your data analysis expertise to drive continuous improvement and strategic