Senior Reimbursement & Data Analytics Lead

Bluecross-Blueshield-of-Vermon; Berlin (VT); Hybrid; USD 74,000 - 90,000; Full time

Benefits offered by this job

Dental coverage (employee)

Wellness Program

401(k) with employer match

Life Insurance

Disability Insurance

Combined time off (CTO) – 20 days + 10

Job summary

Blue Cross and Blue Shield of Vermont is seeking a Senior Reimbursement Programs Analyst to join the Data, Governance, and Healthcare Economics team in a hybrid Berlin, VT role. You will provide data, reporting, and analytical support for provider reimbursement and value-based care initiatives, building models and influencing strategic decisions.

The ideal candidate brings 5–7 years in managed care with 3–5 years in reimbursement, strong Excel skills, and SAS knowledge.

Qualifications

• Bachelor’s degree in health care, business, statistics, math or a closely related field required, advanced study desirable.
• Five to seven (5-7) years of closely related experience with one to three (1-3) years of demonstrated independent work required.
• Three to five (3-5) years of managed care and health insurance experience, including experience in reimbursement methodologies, data research and reporting preferred.
• Knowledge of commercial and Medicare payment methodologies strongly preferred.
• Advanced Microsoft Excel required, and SAS programming knowledge strongly preferred.

Responsibilities

• Provide data, reporting, and analytical expertise to strategic teams focused on provider reimbursement and value-based care initiatives.
• Calculate, monitor, and track performance, use data to support informed business decisions, and participate in the decision-making process.
• Prepare financial and utilization models to illustrate the impact of changes to provider reimbursement, contract provisions, medical policies and practices, benefit plans, products, and quality improvement activities.
• Prepare and maintain documentation related to standard operating procedures as well as routine and special projects.
• Participate in meetings with external parties (employer groups, providers, regulators, etc.), develop presentations, and convey information to advance the Plan’s strategic objectives and fulfill the Plan’s obligations.
• Mentor junior staff as required

Skills

Excel

Data analysis

Reporting

SAS programming

Education

Bachelor's degree in health care, business, statistics, math or a closely related field

Advanced study desirable

Tools

SAS

Job description

Blue Cross and Blue Shield of Vermont is seeking a Senior Reimbursement Programs Analyst to join the Data, Governance, and Healthcare Economics team in a hybrid Berlin, VT role. You will provide data, reporting, and analytical support for provider reimbursement and value-based care initiatives, building models and influencing strategic decisions.

The ideal candidate brings 5–7 years in managed care with 3–5 years in reimbursement, strong Excel skills, and SAS knowledge.