Sr Data Analyst - Value-Based Care

Wellmark Blue Cross and Blue Shield; Des Moines (IA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Wellmark Blue Cross Blue Shield in Des Moines is seeking a Senior Network Innovation Analyst to join a cross-functional product team supporting Network Payment Strategy and Network Performance. You will combine internal and external data with stakeholder insights to identify opportunities and translate findings into actionable recommendations.

The role requires analyzing complex data, mentoring teammates, and communicating technical concepts to diverse audiences.

Qualifications

• Bachelor's degree or direct applicable work experience.
• 5+ years of experience: pulling reports, analyzing complex data (e.g., clinical outcomes, claims data, utilization trends) and performing statistical analyses and data modeling.
• Health insurance or healthcare industry experience.
• Proficiency with Microsoft Office applications, including Excel, ability to create/ad hoc reports, and PowerBI experience preferred.
• Proficiency in SAS and SQL for data extraction, manipulation, and analysis; ability to learn new tools quickly.
• Strong consultation, relationship management, and critical thinking to influence stakeholders.
• Strong written and verbal communication skills with the ability to present to varied audiences.
• Attention to data accuracy and integrity; ability to educate stakeholders on technical subjects.
• Experience coaching and mentoring others.
• Valid Driver’s License with travel <5%.
• HROR proficiency preferred.

Responsibilities

• Develop new cost and quality initiatives and reporting using internal data sources and vendor relationships.
• Provide actionable data and recommendations to providers related to medical cost and quality; meet with assigned ACOs to review performance.
• Develop opportunity projections and determine viability of opportunities to support strategic decisions on medical cost and quality.
• Mentor and provide guidance to other Network Innovation Analysts.
• Serve as a business liaison for Network Innovation on project initiatives.
• Extract, analyze, interpret and integrate data from internal and external sources to support recommendations to stakeholders.
• Ensure data integrity by performing QA checks for vendor reporting and monthly dashboard verification.
• Maintain relationships with providers and vendors to communicate Wellmark’s value-based reimbursement strategy.
• Support stakeholders in monitoring progress towards goals with ROI analyses.
• Document and monitor value-based provider reimbursement initiatives.

Skills

Analytical thinking

Stakeholder consulting

Written & verbal communication

Mentoring / coaching

Education

Bachelor's degree or direct applicable experience

Tools

SAS

SQL

Power BI

Excel

Job description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Learn more about our unique benefit offerings here.

Job Description

The health care industry is evolving and Wellmark is working to help change it for the better. Help shape network performance products that support better decisions about health care cost, quality, and value.

About the Role:

Also known internally as a Senior Network Innovation Analyst, you will be a senior analytical partner on a cross-functional product team supporting Network Payment Strategy and Network Performance. You will combine complex internal and external data with stakeholder and customer insights to identify opportunities, independently frame ambiguous business problems, evaluate solution options, and measure outcomes. Your analyses and recommendations will influence product priorities, value-based payment initiatives, and network performance strategies. You will also translate technical findings into clear data stories for health care organizations, leaders, and internal partners. Success in this role requires analytical depth, business curiosity, strong stakeholder consultation, and the ability to independently frame ambiguous business problems, lead complex analyses, and translate findings into actionable, evidence-based recommendations.

About You:

You are inquisitive and focused on making data-driven conclusions, decisions, and recommendations to achieve business goals. You feel effective when you can extract, analyze, interpret, and integrate data to monitor and implement strategic, innovative initiatives. You thrive as part of an agile product team, partnering across disciplines, adapting to changing priorities, contributing to planning and refinement activities, and incorporating stakeholder feedback into iterative solutions. In addition, you have strong written and verbal communication skills that aid you in consulting, collaborating and effectively communicating complex concepts to varied audiences. You enjoy mentoring, coaching, sharing knowledge, and providing guidance to others, while building and maintaining collaborative relationships with internal and external stakeholders.

Candidates currently residing in the Des Moines, IA metro area preferred.

This position will work a hybrid schedule of at least 3 days in Wellmark's Des Moines office (Tuesday-Thursday), with Monday & Friday remote option.

Qualifications

Required Qualifications - Must have:

• Bachelor's degree or direct and applicable work experience.
• 5+ years of experience:
• Pulling reports, analyzing, and interpreting complex data – e.g., clinical outcomes, claims data, utilization trends, etc. Ability to interpret and integrate data, or perform statistical analyses and data modeling techniques.
• Health insurance, health care, or related industry experience.
• Proficiency with Microsoft Office applications, including Excel. Ability to create or customize ad hoc reports and knowledge of formulas, vlookups, linking spreadsheets or data sources, data summarization/visualization, etc. PowerBI experience preferred.
• Proficiency in SAS and SQL for data extraction, manipulation, and analysis and the technical aptitude to learn new data management and analysis tools or methodologies quickly.
• Strong consultation, relationship management, and critical thinking skills. Ability to develop business acumen and ask meaningful questions in order to effectively consult with and influence stakeholders.
• Strong written and verbal communication skills with the ability to communicate complex concepts to varied audiences. Ability to develop and deliver presentations.
• Attentive to details. Ability to collect, monitor, and assess the accuracy, validity, and integrity of data.
• Ability to educate stakeholders on complex, technical subjects.
• Experience coaching and mentoring others.
• Valid Driver’s License with intermittent travel, less than 5%.
• Proficiency in HROR preferred.

Additional Information

What you will do:

• Develop new cost and quality initiatives and reporting using internal data sources and vendor relationships.
• Provide actionable data and recommendations to providers as it relates to medical cost and quality. The Analyst will meet with assigned ACO’s to review performance and assist with cost and quality initiatives that drive ACO performance.
• Develop opportunity projections and determine the viability of various opportunities to support strategic decision making as it relates to medical cost and quality and drive Wellmark’s value proposition to stakeholders.
• Support other Network Innovation Analysts by mentoring and providing guidance and industry expertise.
• Serve as a business liaison for Network Innovation on project initiatives.
• Extract, analyze, interpret and integrate data using internal and external data sources to develop initiatives, support recommendations and draw conclusions to internal and external stakeholders to achieve business goals.
• Ensure data integrity by performing quality assurance checks for vendor reporting. Will collaborate with other analysts to conduct monthly verification of the vendor dashboards.
• Maintain collaborative relationships with internal and external stakeholders, including providers and vendors, to communicate Wellmark’s value-based reimbursement strategy and present utilization, financial and clinical information clearly and accurately.
• Support the Network Engagement team in creating and maintaining relationships with provider groups by identifying, initiating and establishing appropriate internal and external contacts and sources needed for information sourcing.
• Support stakeholders in monitoring progress towards goals by demonstrating the comprehensive impact of recommendations (e.g., illustrate and explain results of return on investment and/or program evaluation analyses).
• Support Network Innovation initiatives by documenting and monitoring value based provider reimbursement initiatives.
• Perform routine analysis for Wellmark leadership to monitor reimbursement methodologies for effectiveness. Apply qualitative and quantitative techniques to interpret provider reimbursement data, identify opportunities and provide recommendations as appropriate.
• Other duties as assigned.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at [e-mail]

Please inform us if you meet the definition of a "Covered DoD official".

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.