Lead GM Program Analyst
- 📅
- Nov 25, 2019 Post Date
- 📅
- 191476 Requisition #
• Bachelor’s Degree in Business, Finance or Information Systems/Science (or equivalent work experience)
• 7+ years of relevant more experience
• Experience in program or project management with the ability to ensure adherence to budget, schedule, and scope
• Experience gathering, analyzing large datasets and presenting into business intelligence
• Demonstrated experience with Tableau or other data visualization software programs preferred
• Experience in Budgeting, FRPs & RFQs
• Knowledge of SQL programing skills with emphasis in large datasets
• Working experience Microsoft applications (PowerPoint, Excel and Visio)
• Experience dealing with internal and external customers
• Excellent oral/written communication skills required Specific duties:
• Design, implement, and manage ACA prospective & retrospective programs (both internal & vendor based)
• Work with management in establishing operational goals and defining benchmarks metrics for Commercial Risk Adjustment Programs
• Evaluate the effectiveness of programs and provide regular summary of programs status and enhancement options
•Translate operational metrics into business results and forecasts
• Oversee annual HHS Risk Adjustment Data Validation (RADV) audit including managing vendor activity and ensuring compliance with CMS regulations
• Statistical Analysis/benchmarking, RADV Error Rate forecasting
• Keep informed of regulations impacting the ACA as it relates to Risk Adjustment
• Work with internal and external customers to resolve issues
• Own provider and vendor payment process
• Oversee program operating budgets and support related finance / billing functions
• Ensure timely contract renewals and RFP process when necessary
• Responsible for provider and member communications from draft, approval to distribution
• Perform specific duties of the Lead Program Analyst as required
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and 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. Celebrating and embracing 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 Independence, 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
IBX is an Equal Opportunity 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 Independence Blue Cross 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 Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.