Plan Performance Analyst

Internal Audit and Compliance serves our Company and our customers by promoting integrity, efficiency and compliance with applicable standards, laws and regulations, and by systematically monitoring, evaluating and communicating risk in support of the Company's objectives.

Plan Performance provides assurance on our product service commitments by evaluating the timeliness, accuracy and delivery of our products and services to comply with our customer, National Committee for Quality Assurance (NCQA) Accreditation and Blue Cross Blue Shield Association (BCBSA) requirements.

To assist with the Plan Performance process, the Plan Performance Analyst will:

* Perform transactional (claims and inquiries) and/or operational audits
* Support the completion of BCBSA scorecards
* Adopt audit program changes mandated by BCBSA
* Collaborate with business areas on identified errors to pinpoint opportunities for improvement
* Advance policies and practices to ensure the execution of a sound program that maintains the integrity of internal procedures
* Expand partnerships with business areas and key personnel throughout the organization

• Bachelor's Degree
• Minimum of 2 years of experience in areas such as the healthcare field, quality improvement strategies, regulations related to quality, project management, and/or methods for data analysis techniques and interpretation
• Experience with project management, organizational and analytical skills, and continuous improvement in order to independently identify and evaluate opportunities for improvement
• Provide support on complex project/audit scopes and assist in the fulfillment of work/audit plans to achieve the objectives of projects/audits
• Strong communication skills, both orally and written, along with positive collaboration and excellent interpersonal skills
• Experience handling day to day decisions with minimal guidance
• Experience working with management to determine priorities and planning that support the direction of a division
• Proficient in Microsoft Word, Excel and Power Point
• Willingness to travel as required for training, collaboration and education purposes
• Experience meeting stringent deadlines and managing changing priorities
• Experience presenting data or information for the purposes of proposal or decision making preferred
• Knowledge of data analysis techniques and interpretation preferred
• Experience in a position interacting with various levels of associates and management preferred
• Extensive knowledge of claim and inquiry processing across multiple lines of business preferred
• Knowledge of Blue Cross and Blue Shield Association audits and guidelines strongly preferred
• Experience with ITS Gen/Inq and Plan-to-Plan inquiries preferred
• Experience with the following technologies preferred: Adobe, Navigator, CIS, FileNet, TotalView, InfoProviders

Note: Willing to fill at a higher level based on experience.

The work location for this position will be hybrid (onsite/remote).