Senior Data & Reporting Specialist
Responsible for creation, evaluation, and analysis of all appeals and grievances reporting. Assess business requirements and implement solutions. Business tracking, trending, and analysis of all data points. Respond to requests from management that feature research, investigation, evaluation, documentation, and presentation of findings including recommendations. Development of Adhoc reports from both internal and external business partners and customers. Develops DLPs and maintains/updates as needed. Supports the implementation of new procedures by evaluating impacted areas, meeting with staff, training staff, using feedback from staff and incorporate into ongoing development. Designs and evaluates pre and post workflows and processes. Lead audit meetings, and facilitate cross functional responses to auditors. Validation of audit universes, and ongoing discrepancy tracking. Acts as a conduit for leadership decision-making pertaining to all A&G related activities and systems.
* Bachelor's degree in Business Administration preferred.
* In addition to degree, minimum 5+ years proven working experience in a business unit necessary or equivalent external work experience. Demonstrated effective project management skills necessary.
* Considerable knowledge of project management methods, best practices and analysis.
* Proven effective communication and analytical skills required to covey complex ideas and concepts to users, business systems analyst and management.
* Effective facilitation and presentation skills necessary to demonstrate business solutions in a clear and concise manner.
* Demonstrated ability to define business solutions, make decisions, identify problems, coordinate resources and implement changes.
* Must be detail oriented and understand corporate objectives. Ability to follow through on project life cycle while maintaining target deadlines.
* Must be able to work independently on projects and demonstrate strong and effective leadership skills.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Diversity, Equity, and Inclusion
At AmeriHealth, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At AmeriHealth, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
AmeriHealth is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.