Plan Design Specialist jobs in Massachusetts

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

The Business Data Analyst - Customer Experience Specialist uses business data and statistical methods to provide customer insight and suggest areas and methods of improving the customer experience. Primarily focused on data and analytics that support corporate First Call Resolution (FCR) and Net Promotor Score (NPS), this position is responsible for analyzing raw data and providing actionable recommendations to improve the customer experience. Additionally, the Business Data Analyst - Customer Experience Specialist supports all operational regulatory reporting and ensures compliance with both the Massachusetts Executive Office of Human Services and New Hampshire Department of Health and Human Services regulatory reporting requirements for the ACO, SCO and MCO programs. Implements the analytical approaches and methodologies. Presents customer insight and recommendations to all levels of management for decision making and strategic planning. Controls and develops internal/external information sources for business analysis. Analyzes critical data and works closely with business leaders across the organization to develop strategies to drive improvements to the customer experience.

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

Key Functions/Responsibilities:

• Monitors actual FCR and NPS performance against corporate targets; presents findings; proactively investigates and communicates explanations for variation and conducts root cause analysis.
• Provides critical data analysis and recommendations to establish corporate goals related to FCR and NPS.
• Conducts deep analysis on data related to FCR and NPS, reviews member surveys, listens to member calls and identifies trends and opportunities for improvement.
• Works with business leaders to develop strategies and work plans to improve FCR and NPS scores to meet corporate goals.
• Provides data insights targeted at improving upstream processes and improving the customer experience.
• Serves as primary liaison with customer survey vendor to ensure file exchanges are accurate, survey quotas are met and critical communication regarding operations takes place.
• Works with customer survey vendor to identify cost efficiency opportunities, confirm contractual obligations are met and maximize the value of the relationship.
• Attends customer survey vendor's international conference and conducts benchmarking with other companies in an effort to identify best practices related to consumer centricity.
• Works closely with business leaders at all levels across the organization to bring actionable data and customer insights and recommendations for improvement of corporate FCR and NPS scores.
• Target opportunities to share the voice of the customer across the organization in an effort to improve the customer experience and connect to the organization's consumer centricity strategic framework.
• Play a critical lead role in organizational efforts to reach FCR and NPS goals.
• Extract reports from multiple sources (e.g. operations, IT, customer feedback).
• Build systems to transform raw data into actionable business insights.
• Develops, maintains, and communicates key metrics and reports for business partners, highlighting areas for opportunity and improvement. Drives and supports initiatives that address areas of opportunity.
• Prepares MA and NH state regulatory reports for COO Division.
• Provided data and analytics to support the monthly publication of operational dashboards for the COO Division, gathering key operational metrics across the COO Division and evaluating progress of each metric against the established target.
• Responsible for supporting corporate initiatives and projects.
• Stay informed with the latest industry trends and best practices.

Qualifications:

Education:

• Bachelor's degree in required. Candidates possessing an Associate's degree and at least 7 years of relevant analytical/customer service experience in a healthcare will be considered.
• Master's Degree in Business Administration or related field preferred.

Experience:

• 7 or more years of progressively responsible experience in business or analytics required.

Preferred/Desirable:

• Consumer data and analytic experience in First Call Resolution and/or Net Promoter Score.
• Experience with speech analytics.
• Experience working in or supporting a service center.

Competencies, Skills, and Attributes:

• Expert analyst with an ability to translate findings into real world solutions.
• Ability to present sophisticated analysis in an easily understood and professional manner to all levels of the organization.
• Generalist mindset: recognizes organizational interdependencies as they relate to operational performance.
• Strong team player.
• Effective collaborative and proven process improvement skills.
• Superior oral and written communication skills; ability to interact within all levels of the organization.
• A strong working knowledge of Microsoft Office products, including database skills.
• Working knowledge of Tableau and pivot tables
• Demonstrated ability to successfully plan, organize and manage projects.
• Detail oriented, excellent proof reading and editing skills.
• Ability to use well developed interpersonal skills to direct and influence the efforts of others, both internally and externally.
• Ability to conceptualize and envision the impact of change, and propose new ways to do Business.
• Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze Business problems. Project management skills a plus.
• Strong understanding of health care data and analytical methodologies.
• Effective collaborative and proven process improvement skills.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.