Provider Analyst

This job was posted by https://www.kansasworks.com : For more

information, please see: https://www.kansasworks.com/jobs/13287170

Blue Cross and Blue Shield of Kansas is seeking a highly skilled and

proactive Provider Analyst with a specialized focus on Uniform Data

System (UDS) reporting and transmittals. This hybrid role supports the

development of standardized reporting, predictive analytics, and

advanced financial modeling for our healthcare network, while also

ensuring data integrity and compliance with UDS specifications. The

ideal candidate will demonstrate technical expertise, strategic

thinking, and a commitment to enhancing efficiency, data accuracy, and

regulatory alignment across transmittals and performance analysis.

This position is eligible to work remotely, hybrid or onsite in

accordance with our Telecommuting Policy. Applicants must reside in

Kansas or Missouri or be willing to relocate as a condition of

employment.

• Why Join Us?**
• **Family** **Comes First**: Total rewards package that promotes the
  
  

idea of family first for all employees.

• **Professional Growth Opportunities:** Advance your career with
  
  

ongoing training and development programs.

• **Dynamic Work Environment:** Collaborate with a team of passionate
  
  

and driven individuals.

• **Trust:** Work for one of the most trusted companies in Kansas
• **Inclusive Work Environment:** We pride ourselves on fostering a
  
  

diverse and inclusive workplace where everyone is valued and

respected.

**What youll do**

Data Analysis & Insights

• Analyze financial and operational data to identify trends, patterns,
  
  

and discrepancies.

• Develop advanced predictive models to forecast financial and
  
  

operational outcomes.

• Conduct benchmarking analyses to compare provider performance
  
  

against market and competitor standards.

• Audit and validate UDS transmittals to ensure compliance with payer
  
  

and federal reporting specifications.

• Perform root-cause analysis and identify trends in data
  
  

discrepancies related to UDS submission criteria.

Standardized Reporting & Visualization

• Create and maintain dashboards in Power BI to deliver standardized
  
  

monthly and quarterly reports.

• Automate data querying and visualization processes to reduce ad hoc
  
  

requests and improve workflow efficiency.

• Incorporate UDS-specific data elements and submission tracking into
  
  

dashboards and reports to support compliance monitoring.

Scenario Modeling & Network Optimization

• Design scenario models to evaluate the financial and operational
  
  

impacts of network changes, including provider additions or

removals.

• Support annual and quarterly assessments of network adequacy and
  
  

alignment with market demands.

• Identify optimization opportunities in UDS data submission workflows
  
  

by analyzing submission rules and allowable adjustments.

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Collaboration & Stakeholder Engagement

• Partner with teams across the organization to integrate financial
  
  

and quality metrics into decision-making processes.

• Collaborate with Network Strategy and Contracting teams to ensure
  
  

data insights drive meaningful change.

• Work cross-functionally with compliance, quality, and IT teams to
  
  

ensure alignment of UDS data structures and reporting workflows.

Process Improvement & Compliance

• Streamline workflows by adopting advanced data integration tools and
  
  

reducing reliance on manual processes.

• Ensure data integrity and maintain compliance with healthcare
  
  

regulations and standards.

• Establish and document procedures for auditing, validating, and
  
  

correcting UDS data to meet specification standards.

• Continuously review updates to UDS submission guidelines to ensure
  
  

all transmittals reflect the most current requirements.