At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.
The Impact You Will Have
Blue Cross and Blue Shield of Minnesota is hiring a Senior Submissions/Encounter Healthcare Data Analyst in Eagan, MN. In this role, you will support the Submissions Team by performing data analysis, quality assurance, and regulatory submissions with a focus on our government products including Affordable Care Act (ACA), Minnesota Medicaid, and Medicare Advantage (MA). You’ll collaborate with business analysts, actuaries and other cross-functional teams to deliver accurate reports, resolve risk adjustment challenges and provide data-driven solutions.
This position requires expertise in healthcare data—including claims, membership, and provider information—along with hands-on experience in file sets such as 837 claim files, MAO-002/04 response files, and EDGE server response files. You will also develop Power BI dashboards and leverage expert-level SQL skills to ensure compliance and actionable insights.
Candidates must have strong healthcare data analytics experience, regulatory reporting knowledge, and basic familiarity with risk adjustment methodologies, combined with hands-on skills in SQL and Power BI or Tableau. Encounter Data submissions experience focused on ACA, Medicaid, and/or Medicare Advantage is essential. Knowledge of CMS ACA EDGE, Medicare Advantage response files (MAOs), and/or Minnesota Medicaid rejection reports is highly valued. Proficiency with healthcare file formats, understanding of CMS guidelines, and excellent problem-solving abilities are important. Strong communication and collaboration skills are vital for guiding teams and supporting organizational goals in a fast-paced, regulated environment.
Your Responsibilities
- Uses databases for analysis and dissemination of information.
- Performs complex analysis of data.
- Researches, analyzes data, applies statistical methods when appropriate, and provides interpretation of outcomes.
- Identifies issues to be researched, determining affected areas, estimating the impact and contributing to the resolution.
- Implements improvements to process, analysis, and research methods.
- Works with principal positions and management to understand and interpret the impacts to cost and quality of proposals using relevant data sources and analyti