Blue Cross and Blue Shield of Nebraska

Analyst

• Develop reports to track, trend, and analyze metrics for evaluating performance under value-based contracts and across the contract portfolio
• Create, modify, maintain, and enhance business processes, contracts, program data, and methodologies supporting value-based care initiatives
• Develop financial models, processes, and analytic-tool solutions for timely and accurate completion of value-based care initiatives
• Monitor and reconcile value-based care financial payment processes and performance measurements, including finance/cost and utilization
• Interpret, communicate, and present results to management in clear formats to support fact-based decision-making
• Update financial dashboards for all levels of leadership
• Build and maintain relationships with internal stakeholders and external client contacts, including providers, VBC partners, clinicians, vendors, BCBS Association, Blues Plans, and auditors
• Participate in internal and external audits, surveys, process and procedure documentation, system modernization changes, and related value-based care activities
• Maintain knowledge of business processes, policies, and procedures and evaluate the impact of federal and state regulatory or BCBS Association mandate changes

Value Based Analyst

Vice President

• Design and lead enterprise strategies to manage total cost of care and affordability
• Direct analytics for trend, forecasting, and provider economics across all lines of business
• Partner with actuarial, finance, market segment, network, and value-based care leaders to inform pricing, contracting, and value-based strategy
• Lead the trend and affordability committee
• Lead population health analytics, stratifying populations by cost, condition, and risk
• Identify actionable cost and utilization drivers
• Develop affordability strategies using predictive risk identification and personalized member engagement
• Collaborate with the Chief Medical Officer and medical and pharmacy management leaders to quantify opportunities and outcomes
• Establish methods to measure utilization, unit cost, acuity, and trends
• Establish affordability targets, measurement frameworks, and reporting
• Translate data and analytics into strategic recommendations for customers, executive leadership, and Board-level audiences
• Lead and develop teams of analysts and economists supporting population health and cost-strategy work
• Oversee provider economics, unit-cost modeling, contract term evaluation, and fee schedule impact analysis
• Partner with market segment leaders and business function owners to create accountable action plans
• Drive action plans to measurable outcomes for specific populations and the enterprise
• Design and test leading indicators and models that proactively influence health outcomes before high-cost events occur
• Advance predictive analytics, event-driven health management, behavioral economics, and personalized interventions

Value Based Analyst

Vice President – Healthcare Economics