[Remote] Senior Healthcare Data Analyst: ACA + EDGE

Note: The job is a remote job and is open to candidates in USA. Blue Cross NC is seeking a highly skilled Senior Data Analyst with expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissions. The role involves serving as a liaison between business stakeholders and technical teams to ensure accurate data submissions, as well as providing analytic support for decision-making processes.ResponsibilitiesConstruct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports) to gather statistical data, ensuring that the most efficient procedures are used to access, investigate, and analyze dataDevelop, analyze, report and interpret complex data for ongoing activities/projects. Ensure that all data is accurate and available to meet establish deadlinesWork collaboratively with customers to complete effective needs analyses to successfully provide analytic support and problem solving assistance to business areasMonitor and perform in-depth analysis of data for customers to determine areas of improvement or where investigation is neededIdentify complex data problems and issues and is responsible for resolutionIdentify complex trends and make recommendations to business areas to effectively assist them with decision making on operational or other business issuesCommunicate meaningful insights by creating charts and slide presentations and presenting findings to all levels of leadership staffMaintain and coordinate existing cross-functional programs, and create and develop new programsSupport and manage complex applications systems on many platforms and manage code migrations and changes between different applications environmentsDevelop, maintain, and monitor reports on system security to ensure user access is appropriate for the specific division. Provide ongoing user support for ad hoc reporting, questions, queries, and problem supportEnsure appropriate security and privacy for all data that contains PHI fields. Resolve all security and privacy issues in the dataRepresent department on enterprise project teams and process optimization efforts as neededServe as a mentor/coach for less experienced employeesSkillsBachelor's degree or advanced degree (where required)5+ years of experience in related fieldIn lieu of degree, 7+ years of experience in related fieldDeep expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissionsStrong experience with ACA data flows (enrollment, claims, supplemental)HCC modeling and reconciliation of EDGE outputsAdvanced analytical and data validation skillsAbility to construct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports)Experience in data collection, trending, reporting and forecasting functionsAbility to prepare complex data for various internal and external customersAbility to work collaboratively with customers to complete effective needs analysesAbility to monitor and perform in-depth analysis of data for customersAbility to identify complex data problems and issues and is responsible for resolutionAbility to identify complex trends and make recommendations to business areasAbility to communicate meaningful insights by creating charts and slide presentationsAbility to maintain and coordinate existing cross-functional programsAbility to support and manage complex applications systems on many platformsAbility to develop, maintain, and monitor reports on system securityAbility to ensure appropriate security and privacy for all data that contains PHI fieldsAbility to represent department on enterprise project teams and process optimization effortsAbility to serve as a mentor/coach for less experienced employeesBenefitsMedical, dental, and vision coverage along with numerous health and wellness programsParental leave and support plus adoption and surrogacy assistanceCareer development programs and tuition reimbursement for continued education401k match including an annual company contributionAnnual Incentive Bonus*401(k) with employer matchPaid Time Off (PTO)Competitive health benefits and wellness programsCompany OverviewIt's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. It was founded in 1933, and is headquartered in Durham, North Carolina, USA, with a workforce of 5001-10000 employees. Its website is https://www.bluecrossnc.com/.Company H1B SponsorshipBlue Cross NC has a track record of offering H1B sponsorships, with 2 in 2026, 4 in 2025, 1 in 2024, 2 in 2023, 5 in 2022, 13 in 2021, 5 in 2020. Please note that this does not guarantee sponsorship for this specific role.