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Residency in or relocation to Louisiana is preferred for all positions.
Applicants must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support. Louisiana Blue will not provide current or future employment-based immigration sponsorship or other immigration support for this opportunity, including H-1B, L-1, O-1, H-1B1, E-3, TN, or J-1 sponsorship or F-1 OPT/STEM OPT/CPT support. Applicants who would require such sponsorship or employer support during their employment should not pursue this opportunity.
Position Summary
The Healthcare Price and Transparency Analyst develops and supports reliable analytical solutions that improve price transparency and provider reimbursement operations. The role uses SQL, analytical and reporting tools, healthcare data, and business knowledge to analyze and validate data, research complex issues, develop reporting and analytics solutions, support regulatory and industry submissions, and translate operational requirements into actionable insights. The role is an individual contributor and reports to the Manager, Healthcare Price and Transparency.
What You Will Do
- Support price transparency research, analytics, reporting, and regulatory and industry submissions for programs and processes such as Blue Axis/NCCT, machine-readable files, shopper and price comparison tool programs, and qualified payment amount calculations.
- Develop and maintain analytical and reporting solutions for Provider Reimbursement, Payment Integrity, Medical Coding, and other provider areas, including data analysis and validation, issue investigation and resolution, and process improvement.
- Translate business requirements into analytical solutions and create and maintain documentation for data sources, business rules, calculations, controls, testing, and reporting processes.
- Collaborate with internal and external partners to complete projects and resolve issues while following applicable privacy, security, data-governance, and compliance requirements.
Core Competencies
- Critical thinking and analytical problem-solving to evaluate results, identify inconsistencies, investigate issues, understand business processes and operational workflows, and contribute to sustainable analytical and reporting solutions.
- Attention to detail and ownership of accurate, complete, timely, and well-documented work.
- Clear written and verbal communication and collaboration skills, including the ability to explain financial, healthcare, and technical topics to technical and nontechnical audiences and work effectively with end users, business stakeholders, technical teams, leaders, and external partners.
- Ability to manage priorities, meet deadlines, and adapt to changing regulatory, reporting, and business needs.
Level Expectations and Minimum Qualifications:
Associate Healthcare Price and Transparency Analyst | Beginner | Learn and Support
- Bachelor's degree in a quantitative, business, technology, or healthcare field; four years of related experience may substitute for the degree.
- At least six months of relevant work experience or LA Blue internship experience involving data, analytics, healthcare, IT, finance, reporting, or business operations.
- Foundational technical skills, including SQL query writing, data joins and tables, and basic Microsoft Excel; Power BI and/or Tableau experience is preferred but not required.
- Foundational analytical skills, including data validation, testing, reporting, data visualization, and process documentation, with healthcare claims, provider data, provider reimbursement, and medical coding knowledge preferred but not required.
Healthcare Price and Transparency Analyst | Developing Professional | Develop and Deliver
- Bachelor's degree in a quantitative, business, technology, or healthcare field; four years of related experience may substitute for the degree.
- At least two years of analytical experience in healthcare, IT, finance, business operations, or another related industry; healthcare analytical experience and knowledge of claims, provider data, reimbursement methodologies, and/or medical coding concepts are preferred but not required.
- Strong SQL development experience, including writing and maintaining complex queries, stored procedures, tables, views, and reporting datasets in a structured and maintainable manner.
- Proficiency in Microsoft Excel, including PivotTables, complex formulas, and Power Query; VBA experience is preferred. Experience with Power BI and/or Tableau for analytical, reporting, and visualization solutions is required.
- Strong analytical and critical-thinking skills, including independently testing and validating solutions, investigating and resolving discrepancies, and developing practical, well-documented solutions. Ability to understand business processes and operational workflows, determine requirements, and translate them into meaningful analytical and reporting solutions while collaborating across business and technical areas.
Senior Healthcare Price and Transparency Analyst | Experienced | Guide and Deliver
- Bachelor's degree in a quantitative, business, technology, or healthcare field; four years of related experience may substitute for the degree. A master's degree such as an MBA, MPH, MS, or MA is preferred.
- At least four years of progressively responsible analytical experience, including healthcare analytical experience and expertise in one or more areas such as provider reimbursement, payment integrity, medical coding, and/or healthcare price transparency.
- Extensive SQL development experience, including complex queries, tables, views, stored procedures, and functions, with demonstrated ability to design structured, maintainable, and reusable analytical solutions for complex healthcare data.
- Strong Microsoft Excel skills, including PivotTables, complex formulas, and Power Query, with VBA experience preferred; extensive Power BI and/or Tableau experience for analytical, reporting, and visualization solutions.
- Proven ability to lead complex cross-functional analytical projects, translate business, operational, and regulatory requirements into streamlined solutions, and drive complex issue resolution while maintaining accurate and well-documented work. Demonstrated ability to influence stakeholders, communicate recommendations to leadership, and provide technical direction, mentoring, and review of analytical work.
- A medical coding designation such as CPC or CPHC is preferred but not required.
Level Placement
Level placement is based on the full scope of qualifications, including SQL proficiency, analytical judgment, independence, healthcare knowledge, assignment complexity, cross-functional work, project leadership, and organizational influence. Years of experience are one factor and are not the sole basis for level determination.
An Equal Opportunity Employer
All internal employees please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
