Data Quality Integrity Analyst

At Horizon Blue Cross Blue Shield, we are dedicated to empowering our members to achieve optimal health. With over 90 years as a leading health solutions provider, we are committed to driving innovations that enhance healthcare quality, affordability, and member experience. Our mission is personal; we serve 3.5 million members who are our neighbors, friends, and family. We believe that fostering a diverse and inclusive environment allows our talented employees to thrive. When our employees succeed, so do we.

Key Responsibilities:

Lead projects aimed at enhancing HEDIS, Stars, accreditation, and state performance.

Manage vendor relationships to support initiatives designed to boost quality performance.

Develop and implement quality assurance processes to ensure accurate and complete regulatory reporting data.

Act as an analytic liaison for complex clinical projects, utilizing multiple data sources and teams to drive informed business decisions across clinical, network, and value-based performance models.

Translate organizational strategies and analytic requirements into actionable data analytics designs and technical specifications.

Create integrated analytic datasets, summarize findings, and deliver insights to identify business opportunities and resolve key questions. Present findings professionally through reports, charts, and presentations.

Collaborate across analytical and business units to communicate analytic designs, results, and interpretations, offering recommendations for effective application in business decisions.

Document methodologies, findings, and processes clearly and maintain thorough documentation for analytic projects, including SAS coding comments.

Present analytic findings to leadership teams, highlighting actionable opportunities and strategic solutions.

Deliver technical training on analytics design, data, programming, quality assurance, statistics, and documentation to junior analysts.

Experience and Skills:

High School Diploma or GED required; Bachelor's degree in Math, Statistics, Data Science, or Public Health preferred, or relevant experience in lieu of degree.

A minimum of 5 years in data analytics, HEDIS, SAS, or related fields is required.

At least 5 years of experience analyzing healthcare data, particularly HEDIS data and relational healthcare databases with a focus on medical, pharmacy, and behavioral data.

Knowledge:

Extensive knowledge of the U.S. healthcare industry, health plan operations, claims data, clinical data, and coding practices is essential.

Familiarity with visualization and BI tools, particularly Tableau, is preferred.

Skills and Abilities:

Proficiency in MS Excel for data analysis and reporting.

Strong organizational skills with keen attention to detail.

Adept at navigating a fast-paced, team-oriented environment and managing multiple priorities effectively.

Self-motivated with the ability to work independently.

Compensation is competitive and considers a variety of factors including education, experience, certifications, geographic location, and internal equity. We offer a comprehensive benefits package, including:

Comprehensive health benefits (Medical/Dental/Vision)

Retirement plans

Generous paid time off (PTO)

Incentive plans

Wellness programs

Paid volunteer time off

Tuition reimbursement

Disclaimer:

This job summary provides a general overview of the role and responsibilities, but it is not an exhaustive inventory of all duties, qualifications, or tasks associated with the position.

Horizon Blue Cross Blue Shield is an Equal Opportunity/Affirmative Action employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status, or disability status as required by law. We are committed to accommodating reasonable requests throughout the recruitment process.