Your Role

The Senior Markets team supports Medicare, Medicare Supplement, Duals, Group Medicare, Prescription Drug Plans and Specialty products. The Business Analyst, Consultant - Medicare will report to the Senior Manager of Program and Project Manager, Medicare Performance Improvement. In this role you will play a key role in leading the collaboration of cross-functional teams and business stakeholders to ensure operational readiness activities are identified, tracked, and completed for a complex portfolio that includes strategic, mandated projects including individual and group products. Understand and comply with Federal, State, Center for Medicare & Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Insurance (DOI) or other regulators, Blue Shield regulatory guidelines, and Blue Shield policies and procedures. This role also initiates Annual Enrollment Period (AEP) Lessons Learned by organizing documentation, collecting feedback, facilitating meetings and successful handoff of issues that require change prior to next Annual Enrollment Period (AEP) cycle.

Your Work

In this role, you will:

• Provide highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Lead the development of annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)
• Develop, prepare, and analyze reports with highly complex analysis and data for management review, and presents to various levels of management
• Define business requirements and provide analysis to increase operational efficiency
• Provide analytical support for multiple, highly complex cross-functional projects simultaneously, establish work plans and timelines, coordinates with internal and external resources

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience including a minimal 7 years of prior relevant experience
• Requires at least 2 years of experience in health plan operations, preffrably Medicare
• Proven experience creating data visualizations to effectively narratives an actionable member journey with strong persona actions including scenario-based actions
• Practical knowledge of agile and/or SAFe along with project management skills
• Requires practical knowledge of job area typically obtained through advanced education combined with operational experience
• Demonstrated experience with the end-to-end implementation of new products or process improvement impacting multiple business units required
• Demonstrated understanding of Medicare Advantage and Medicare Supplement managed care customer needs, including expected member experiences preferred

Pay Range:

The pay range for this role is: $ 96470.00 to $ 144760.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.