Senior Reimbursement Programs Analyst

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

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Senior Reimbursement Programs Analyst

Regular Full-Time Berlin, VT, US 1 Attachments

Blue Cross and Blue Shield of Vermont is looking for a Sr. Reimbursement Programs Analyst to join our Data, Governance, and Healthcare Economics team. Our company culture is built on an unwavering focus on the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. We offer a balanced and flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401K, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

LOCATION:Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. Fully remote candidates within the state of Vermont (further than 50 miles from our Berlin office), will also be considered.

COMPENSATION: The base salary range for this position is$74,000 - $90,000.Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).

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

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.
• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) – 20 days per year + 10 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at http://www.bluecrossvt.org/about/diversity-equity-and-inclusion .

Attachments (1)

Senior Reimbursement Programs Analyst.docx