- Full Time
- United States
Blue Cross and Blue Shield of Nebraska at a glance
SEC filings mentioning "Blue Cross and Blue Shield of Nebraska": 5 — search EDGAR
Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska is seeking a Risk Adjustment Health Data Analyst to translate complex healthcare data into actionable business insights. This full-time position is available to candidates in Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.
About This Position
As a Risk Adjustment Health Data Analyst, you'll play a vital role in our Risk Adjustment Programs team. Your work will evaluate program performance, quantify clinical and financial outcomes, and uncover opportunities to enhance our service delivery. Through data-driven analysis, you'll guide intervention strategy, strengthen our reporting infrastructure, and inform decisions that directly impact member care.
What You'll Do
- Analyze healthcare claims, pharmacy, lab, and risk adjustment submission records to assess intervention effectiveness and program performance
- Create, maintain, and present reports measuring intervention return on investment, incremental conditions identified, risk score changes, and financial impact
- Partner across departments to fulfill Risk Adjustment analytics requirements, support intervention planning, enhance reporting systems, and resolve analytical challenges
- Monitor healthcare analytics trends, risk adjustment methodologies, analytics tools, and regulatory requirements; recommend process and reporting improvements
- Address ad-hoc analytical requests with strong independent judgment and technical expertise
Skills & Qualifications
Required:
- Bachelor's degree or equivalent professional experience
- 3+ years in data analysis, statistical analysis, or Government program experience (Medicare Advantage, Commercial ACA) with healthcare data including claims, encounters, provider records, or CMS files
- SQL and data analytics proficiency
- Hands-on experience with Microsoft Azure DataBricks
- Advanced Excel skills
- Strong ability to extract meaningful insights from multiple data sources
- Demonstrated experience working across functional teams
- Effective communication with diverse stakeholder groups
Preferred qualifications:
- Agile and Project Management experience
- Demonstrated success building predictive models and performing data quality analysis
- Ability to transform analytical findings into clear, actionable visual reporting
- Experience creating self-service analytics solutions
- Advanced SQL knowledge
- Understanding of health insurance operations and industry trends
- Expertise in Medicare Advantage risk adjustment models, payment mechanisms, and submission requirements
- Proficiency with data manipulation tools such as R or Python
- Experience with PowerBI and/or Tableau visualization platforms
- Capacity to translate technical requirements into business deliverables
- Experience managing external partner relationships with vendors, providers, and brokers
- Master's degree in Business, Analytics, Information Technology, or related field
About Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska champions the health and wellbeing of members and communities through innovative healthcare solutions. As part of Team Blue, you'll find a supportive workplace culture that values diverse backgrounds and perspectives, professional development opportunities, and the meaningful impact that comes from delivering exceptional healthcare coverage.
Next Steps
To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.
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