Healthcare Price & Transparency Analyst

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Execute pricing and transparency reporting tasks to ensure compliance with Blue Cross Association and federal regulations.

• Offer members cost details for common medical procedures, surgeries, treatments, and quality-of-care insights.

• Assist in the reimbursement areas for facilities and professionals through the development of processes, procedures, reports, software, and operational enhancements.

• Work in collaboration with cross-divisional business units, IT, and vendors to enhance reimbursement operations and address organizational information issues.

• Establish an efficient, effective, and compliant technical analytical reporting framework.

• Improve, implement, automate, and oversee the reimbursement operations strategy alongside senior team members and the Manager of Healthcare Price and Transparency.

• Design, configure, implement, maintain, and document transparency cost algorithms for both internal and external transparency initiatives.

• Evaluate reimbursement operations, ascertain business needs, identify areas for improvement, and support the design of business and technology systems.

• Suggest enhancements in business processes, system testing, controls, and protocols.

• Conduct data transformation, validation, reporting, and analytics tasks.

⛳️ Requirements

• A Bachelor's degree in a relevant field is mandatory; four years of related experience may substitute for a bachelor's degree.

• A minimum of 2 years of analytical experience in healthcare, IT, finance, or similar industries is required.

• A basic understanding of provider payment methodologies, complex provider contracts, medical coding, clinical editing, and analytic-driven healthcare pricing transparency initiatives is preferred.

• A fundamental grasp of clinical and payment methodologies including per diems, APC, DRG, MPFS, CCI, etc., is preferred.

• Comprehensive knowledge of SQL, covering query writing, data importation, and table and view creation in environments like Microsoft SQL Server, Azure Databricks, and/or Snowflake.

• Experience with analytics and visualization tools such as Tableau and Power BI is required.

• Strong analytical and critical-thinking abilities.

• Exceptional oral and written communication skills, including the capability to clearly present complex financial analyses and technical topics to internal staff and external vendors.

• Extensive proficiency in Microsoft Office, particularly Excel with Pivot Tables, and PowerPoint.

• Ability to operate effectively in a fast-paced and challenging environment.

• A medical coding designation such as CPC or CPHC is preferred.

• Must be legally authorized to work for Louisiana Blue in the United States without employer-sponsored immigration assistance.

• A successful background check and pre-employment drug screening are required before hiring.

🏝️ Benefits

• Resources to enhance well-being and health.

• Opportunities for learning and professional development.

• Development of skills and opportunities for professional growth.

• Chances to contribute to local communities.

• Smoke- and tobacco-free company premises.

• Reasonable accommodation support for applicants with disabilities.