Sr. Clinical Business Analyst

We are hiring a Sr. Clinical Business Analyst at BCBST!

Education

• Bachelor’s Degree required, or equivalent professional experience. Equivalent experience defined as 4 years of professional work experience in a healthcare, clinical operations, or corporate environment.

Licensure

• Registered Nurse (RN) with an active license in the state of Tennessee or a compact state OR Master’s-level Social Worker with an active Tennessee license (e.g., LMSW, LCSW)

Experience

• 3 years of experience in clinical operations, care management, utilization management, population health, or a comparable healthcare setting.
• 2 years of experience in reporting, data analysis, business analysis, or performance improvement.
• 1 year of experience supporting projects, initiatives, or cross-functional workgroups; project management experience preferred.
• Demonstrated experience collaborating with clinical, operational, and technical partners to improve workflows, systems, or performance outcomes.
• Experience evaluating and supporting AI-enabled or advanced analytics solutions, including understanding use cases, data inputs/outputs, limitations, and workflow impacts.

Skills & Competencies

• Strong analytical, critical thinking, and problem-solving abilities.
• Ability to translate clinical and operational needs into clear business requirements.
• Strong judgment related to risk, bias, appropriateness, and governance considerations for analytics and AI-driven tools in clinical settings.
• Proficient in Microsoft Office (Outlook, Word, Excel, Access, PowerPoint); advanced Excel skills preferred.
• Database reporting and data analysis experience.
• Ability to work independently with minimal supervision and collaboratively within a team environment.
• Proven ability to manage multiple projects, priorities, and timelines.
• Excellent oral and written communication skills, including the ability to present findings and recommendations to leadership.
• Strong interpersonal, organizational, and time-management skills.
• Comfort operating in a fast-paced, evolving environment with emerging technologies and changing priorities.

• This is a remote role.
• Candidates should have demonstrated proficiency and comfort working with AI-enabled technologies and tools.

• →Analyze clinical, operational, and financial data to identify opportunities to improve quality, utilization, access, and service delivery. 
• →Lead workflow and process analysis, recommending and implementing evidence-based improvements to enhance efficiency and outcomes. 
• →Translate clinical and business needs into clear requirements and actionable insights in partnership with clinical, operations, IT, and analytics teams. 
• →Provide subject-matter expertise and education on clinical workflows, data interpretation, reporting, and system functionality. 
• →Ensure compliance with regulatory, accreditation, and internal governance standards related to clinical operations and data use. 
• →Support the evaluation, implementation, and optimization of clinical and business processes, applications, and technology-enabled solutions. 
• →Assess, plan, and support responsible adoption of AI initiatives, including use case evaluation, requirements definition, and performance monitoring. 
• →Analyze adoption, performance, and outcome data for technology solutions, identifying risks and opportunities for optimization. 
• →Contribute to policies, controls, and governance frameworks for the use of technology in clinical and operational environments.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices