Position Description
The Senior Operations Consultant is responsible for providing analytical support to various business areas and customers. Also acts as subject matter expert providing technical and/or business knowledge to support decision making processes. Mentors business consultants and business analysts. Collaborates on the development of Medical Value initiatives and business intelligence platforms. Compliments Consultant responsibilities and initiative support by gathering and interpreting customer requirements, competitive information and industry standards.Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, andanticipatedcontributions to meet the needs of the business, along with internal pay equity and externalmarket-drivenrates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may bemodifiedin the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, andit’swhy our employees consistently vote us one of the “Best Places to Work in PA.”
Responsibilities and Qualifications
Ensures extensive research design, comprehensive data collection and sound statistical methods are applied to the cost and utilization forecasts, corporate reporting, programs, and corporate projects.
Ensures appropriate development of research proposals, protocols, information needs, and data analysis plans to support the analysis and assessment of internal and vendor programs involving sales initiatives, contracting, quality improvement, clinical management, cost and utilization trend analysis and benchmarking, pharmacy benefit management, medical affairs, and other Corporate initiatives.
Mentors business areas in the initial assessments, requirements, project plans, solutions, research and selections with a focus on data, information reporting, and analysis. Lead project task execution by ensuring progress, organizing project data, and coordinating team meetings.
Focuses on project collaboration with business areas or external customers where a proficiency in business knowledge exists.
Provides information to customers/clients in development of engagements, materials, events, initiatives, committees, meetings and presentations by gathering needed information and using appropriate frameworks and models in the development of assessment materials.
Provides support for other analytical and reporting needs, trend analysis, financial improvement plans, compliance and regulatory reporting coordination (NCQA, HEDIS, DOH, HHS, CMS, FEP, OPM). Individual will be responsible for performing retrospective trend analysis, business requirement gathering, customer needs assessments, documentation of data needs/source mapping, competitive and industry information.
About Us
We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community.We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best,you’llhelp us live our mission of improving the health and well-being of our members and the communities in which they live.