Sr. Reimbursement Programs Analyst

Job Description

Job Description

Blue Cross and Blue Shield of Vermont is looking for a Sr. Reimbursement Programs Analyst to join our Data, Governance, and Healthcare Economics team. Our company culture is built on an unwavering focus on the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. We offer a balanced and flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401K, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

LOCATION: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. Fully remote candidates (further than 50 miles from our Berlin, VT office), will be considered on a case-by-case basis.

COMPENSATION: The base salary range for this position is $74,000 - $90,000. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).

Sr. Reimbursement Programs Analyst Responsibilities:

• Provide data, reporting, and analytical expertise to strategic teams focused on physician, hospital, and ancillary reimbursement and value-based care initiatives.
• Develop benchmarks; calculate, monitor and track performance, utilize sales data to support informed business decisions, and participate in the decision-making process.
• Prepare financial and utilization models to illustrate the impact of changes to provider reimbursement, contract provisions, medical policies and practices, benefit plans, products, and quality improvement activities.
• Prepare and maintain documentation related to standard operating procedures as well as routine and special projects. Write documentation to describe program development, logic, coding and corrections. Write manuals for users to describe content, definitions, and procedures.
• Participate in meetings with external parties (employer groups, providers, regulators, etc.), develop presentations, and convey information to advance the Plan’s strategic objectives and fulfill the Plan’s obligations.
• Mentor junior staff as required

Sr. Reimbursement Programs Analyst Qualifications:

• Bachelor’s degree in health care, business, statistics, math or a closely related field required, advanced study desirable.
• Five to seven (5-7) years of closely related experience with one to three (1-3) years of demonstrated independent work required.
• Three to five (3-5) years of managed care and health insurance experience, including experience in reimbursement methodologies, data research and reporting preferred.
• Advanced Microsoft Excel required, and SAS programming knowledge strongly preferred.

Sr. Reimbursement Programs Analyst Benefits:

• Health insurance (including vision)
• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) – 20 days per year + 10 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among us and in our communities. We welcome applicants from all backgrounds and experience to join us in our commitment to the health of Vermonters, outstanding member experience, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at http://www.bluecrossvt.org/about/diversity-equity-and-inclusion.

*Full job description attached to ADP job posting.