The Impact You Will Have

Blue Cross and Blue Shield of Minnesota is hiring a Senior Submissions/Encounter Healthcare Data Analyst in Eagan, MN. In this role, you will support the Submissions Team by performing data analysis, quality assurance, and regulatory submissions with a focus on our government products including Affordable Care Act (ACA), Minnesota Medicaid, and Medicare Advantage (MA). You’ll collaborate with business analysts, actuaries and other cross-functional teams to deliver accurate reports, resolve risk adjustment challenges and provide data-driven solutions.

This position requires expertise in healthcare data—including claims, membership, and provider information—along with hands-on experience in file sets such as 837 claim files, MAO-002/04 response files, and EDGE server response files. You will also develop Power BI dashboards and leverage expert-level SQL skills to ensure compliance and actionable insights.

Candidates must have strong healthcare data analytics experience, regulatory reporting knowledge, and basic familiarity with risk adjustment methodologies, combined with hands-on skills in SQL and Power BI or Tableau. Encounter Data submissions experience focused on ACA, Medicaid, and/or Medicare Advantage is essential. Knowledge of CMS ACA EDGE, Medicare Advantage response files (MAOs), and/or Minnesota Medicaid rejection reports is highly valued. Proficiency with healthcare file formats, understanding of CMS guidelines, and excellent problem-solving abilities are important. Strong communication and collaboration skills are vital for guiding teams and supporting organizational goals in a fast-paced, regulated environment.

Your Responsibilities

• Uses databases for analysis and dissemination of information.
• Performs complex analysis of data.
• Researches, analyzes data, applies statistical methods when appropriate, and provides interpretation of outcomes.
• Identifies issues to be researched, determining affected areas, estimating the impact and contributing to the resolution.
• Implements improvements to process, analysis, and research methods.
• Works with principal positions and management to understand and interpret the impacts to cost and quality of proposals using relevant data sources and analytic methods.
• Assists in the implementation of new products and systems by providing actionable information and recommendations that evaluate the impact of the proposed products and systems.
• May represent the division on corporate projects and may have leadership roles on these teams.
• Independently manages issues that may arise on multiple tasks or projects with limited management involvement.
• Acts as a resource for other members of the department and company on business issues and may be responsible for training and guidance of other employees.

Required Skills and Experience

• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 2 years experience using programming and statistical software (SQL), use of various databases and other data sources, and performing analytics.
• Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access.
• Ability to perform and interpret a variety of statistical analyses.
• Demonstrated ability to evaluate and interpret complex data.
• Demonstrated ability to handle multiple tasks with competing priorities.
• Demonstrated problem solving skills.
• Excellent written and verbal communication skills and with an ability to interpret and communicate analytical information to individuals and groups with varying levels of analytics expertise in a clear and concise manner.
• Demonstrated ability to present complex results and conclusions to non-technical audiences and to senior decision-makers.
• Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical, and/or clinical.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Encounter Data submissions experience with a focus on ACA, Medicaid and / or Medicare Advantage strongly preferred.
• Knowledge of CMS ACA EDGE, Medicare Advantage response files (MAOs) and/or Minnesota Medicaid rejection reports.
• Experience with managed care and health care claims
• Experience creating and maintaining reporting in Power BI or Tableau.
• High level expertise with SQL.
• Familiarity with clinical coding (ICD-10-CM) and revenue cycles.
• Bachelor's degree.