BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee टेनेसी स्थित एक स्वास्थ्य योजना प्रदाता है, जो स्वास्थ्य सेवा और बीमा के क्षेत्र में अपने कार्य के माध्यम से 34 लाख सदस्यों को सेवाएँ प्रदान करता है। Blue Cross Blue Shield Association की एक स्वतंत्र लाइसेंसधारी और योग्य Health Insurance Marketplace प्रदाता के रूप में, कंपनी स्वास्थ्य कवरेज को ग्राहक सेवा और समुदाय-केंद्रित देखभाल के साथ जोड़ती है। यहाँ के करियर में विभिन्न पेशेवर अवसर शामिल हैं, जिनमें BlueBridge इंटर्नशिप कार्यक्रम भी है, जो विद्यार्थियों और हाल ही में स्नातक हुए लोगों को अपना करियर शुरू करने में मदद करता है। BlueCross BlueShield of Tennessee ऐसे कार्यस्थल पर भी ज़ोर देती है जहाँ कर्मचारियों को महत्व दिया जाता है, सम्मान मिलता है और उन्हें समावेशित महसूस कराया जाता है।

Senior Clinical Business Analyst - Tennessee Remote

Senior Clinical Business Analyst supporting BlueCross BlueShield of Tennessee’s medical policy operations. The role combines healthcare analytics, process improvement, interoperability, and responsible AI adoption.

विवरण

  • Advance medical policy operations with the Medical Policy Research & Development team through evidence-based practices, process improvement, and AI-enabled solutions.
  • Develop and maintain medical policies through literature surveillance, regulatory and clinical guideline monitoring, and support for interoperability and healthcare digitization initiatives.
  • Evaluate clinical, operational, and financial data to identify improvements in quality, utilization, access, and service delivery.
  • Lead workflow and process analysis and recommend and implement evidence-based improvements.
  • Convert clinical and business needs into requirements and actionable insights with clinical, operations, IT, and analytics partners.
  • Provide subject-matter guidance and education on clinical workflows, data interpretation, reporting, and system functionality.
  • Maintain compliance with regulatory, accreditation, and internal governance standards.
  • Support the evaluation, implementation, and optimization of clinical and business processes, applications, and technology-enabled solutions.
  • Evaluate, plan, and support responsible AI adoption, including use-case assessment, requirements definition, and performance monitoring.
  • Analyze adoption, performance, and outcome data for technology solutions.
  • Help develop policies, controls, and governance frameworks for technology use in clinical and operational settings.

आवश्यकताएँ

  • Bachelor’s degree or equivalent professional experience is required.
  • Equivalent experience means four years of professional work in healthcare, clinical operations, or a corporate environment.
  • Active Tennessee or compact-state RN license, or an active Tennessee master’s-level social work license such as LMSW or LCSW.
  • Three years of experience in clinical operations, care management, utilization management, population health, or a comparable healthcare setting.
  • Two years of experience in reporting, data analysis, business analysis, or performance improvement.
  • One year of experience supporting projects, initiatives, or cross-functional workgroups.
  • Experience partnering with clinical, operational, and technical teams to improve workflows, systems, or performance outcomes.
  • Experience evaluating and supporting AI-enabled or advanced analytics solutions.
  • Strong analytical, critical-thinking, and problem-solving skills.
  • Ability to turn clinical and operational needs into clear business requirements.
  • Sound judgment regarding risk, bias, appropriateness, and governance for analytics and AI-driven clinical tools.
  • Proficiency with Microsoft Office, including Outlook, Word, Excel, Access, and PowerPoint.
  • Experience with database reporting and data analysis.
  • Ability to work independently and collaboratively within a team.
  • Demonstrated ability to manage multiple projects, priorities, and timelines.
  • Excellent written and verbal communication skills.
  • Strong interpersonal, organizational, and time-management abilities.
  • Comfort working in a fast-moving environment with emerging technologies and shifting priorities.
  • Demonstrated proficiency and comfort using AI-enabled technologies and tools.

लाभ

  • Remote work arrangement.
  • Employee position.
  • Equal employment opportunity and nondiscrimination protections.

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