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IT Data Analyst (DC Medicaid)

Company: CareFirst BlueCross BlueShield
Location: Washington
Posted on: May 24, 2020

Job Description:

Resp & Qualifications


The Informatics Regulatory Reporting Analyst has primary responsibility for fully supporting the company's ongoing healthcare business intelligence and informatics related to strategic goals and objectives. The incumbent will be responsible for the design and production of reports required by local and federal regulators, as well as internal operational report specification in addition to providing analyses related to measuring performance and status of programs, initiatives, processes and partners. This roll will provide analytical interpretation of data for evaluation of clinical practices and the development of financial and contractual modeling.


Supports the Business Intelligence/Informatics unit and develops business processes and systems to ensure integrity of the health plan data.

Works with operational teams and IT programmers to identify report criteria that will translate to functional specifications that will turn into meaningful reports, and economic outcome metrics for measurement and reporting. Works with the Operational departments and Informatics staff in designing, conducting and analyzing clinical and financial outcomes studies.

Works to ensure that reports for all jurisdictions are completed in a timely and accurate manner.

Preforms quality reviews on state-required and/or departmental reports related to health care quality improvement initiatives including HEDIS and disease management programs.

Develops financial outcomes methodologies and metrics related to the company's clinical improvement products and services.

Conducts health data economic analysis for CEO, CIO, COO, CFO, Medical Management, Finance, and Contracting/Network Development Departments.

Analyzes provider financial and clinical data to develop and produce physician performance reports.

Assists with preparation of state-required and/or departmental reports related to health care quality improvement initiatives including HEDIS and disease management programs.

Manages multiple data related projects to completion across multiple departments.

Works with the Information Systems department to further develop data access tools and analyze the functionality of external products.

Assists with development and supports new business applications, and assists Senior healthcare analyst with implementation of a technical quality assurance process that ensures that all software development is properly specified, documented, tested, implemented, and feedback received for improvements.


This job has no supervisory responsibilities.


Computer proficiency with statistical analysis, spreadsheets, database and basic SQL.

Good Informatics skills in data/information presentation

Good oral communication, written presentation and interpersonal skills

Mid- level report creation skills.

Clear understanding of health plan operations, workflows and reporting

Experience in data exploration and preparation with large datasets, and in study design and execution required.

Research experience with quantitative models.

Good analytical skills and multi-tasking capabilities.

knowledge of Microsoft Access, Microsoft Excel, Crystal Reports & SQL.

Ability to work independently on complex projects and issues and interaction with other departments.

Knowledge of Health Plan Data and an understanding of the linkages between data, knowledge and decision support necessary to report outcomes

Five years of health care quantitative analysis and the application of advanced statistical techniques experience

Experience with HEDIS and Medicaid reporting preferred


Bachelor's Degree in a related field; Information Technology, public Health or related field is required.

Formal informatics training a plus


To perform the job successfully, an individual should demonstrate the following competencies:

Analytical - Collects and researches data; Uses intuition and experience to complement data.

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.

Project Management - Communicates changes and progress; Completes projects on time and budget.

Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.

Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.

Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.

Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Able to read and interpret written information.

Quality Management - Demonstrates accuracy and thoroughness.

Diversity - Shows respect and sensitivity for cultural differences; promotes a harassment-free environment.

Ethics - Treats people with respect; Keeps commitments; inspires the trust of others; Works with integrity and ethically; Upholds organizational values.

Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; supports organization's goals and values; Supports affirmative action and respects diversity.

Strategic Thinking - Develops strategies to achieve organizational goals; Understands organization's strengths & weaknesses; Analyzes market and competition; Adapts strategy to changing conditions.

Judgment - Displays willingness to make decisions; Includes appropriate people in decision-making process; makes timely decisions.

Motivation - Sets and achieves challenging goals; Demonstrates persistence and overcomes obstacles.

Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources.

Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

Quality Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.

Safety and Security - Observes safety and security procedures; Reports potentially unsafe conditions.

Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.

Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.

Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.

Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.


  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
  • Ability to write reports, business correspondence, and procedure manuals.
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public.


    • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
    • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.


      • To perform this job successfully, an individual should have knowledge of ADP (Total Source/ Workforce)
      • Applicant Tracking System, (Taleo, Workday) Database software
      • Outlook; Human Resource systems;
      • Payroll systems; Spreadsheet software and Word Processing software.




        Equal Employment Opportunity

        CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

        Hire Range Disclaimer

        Actual salary will be based on relevant job experience and work history.

        Where To Apply

        Please visit our website to apply: www.carefirst.com/careers

        Closing Date

        Please apply before: 6/14/2020

        Federal Disc/Physical Demand

        Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


        The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

        Sponsorship in US

        Must be eligible to work in the U.S. without Sponsorship

Keywords: CareFirst BlueCross BlueShield, Washington DC , IT Data Analyst (DC Medicaid), Accounting, Auditing , Washington, DC

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