Business Analyst III Managed Care Operations
Business Analyst III Managed Care Operations
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1 Vacancy
Job Description
Where Youll Work
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Job Summary and Responsibilities
***This position is remote but will be expected to work PST business hours.
Position Summary:
The Business Analyst (BA) III will serve as the internal consultant for the Managed Care Operations team providing analysis reporting and operational support across a variety of functions including credentialing contracting claims provider relations quality/risk care coordination utilization management and business development. They will bridge the gap between operational needs and technology solutions ensuring data integrity and actionable insights for key stakeholders. As part of the BA Hub these roles will also partner closely with the Population Health Analytics function to ensure consistent and accurate reporting across all markets.
Responsibilities may include:
- Lead the analysis and evaluation of data processes and systems related to Managed Care Operations ensuring they align with strategic business goals.
- Oversee and drive improvements across multiple functional areas including credentialing contracting provider relations and care coordination.
- Serve as the lead SME for the Managed Care Operations Hub ensuring the integration of operational needs with data governance analytics and reporting.
- Develop comprehensive business cases for process improvements including cost service and benefit dimensions.
- Manage and coordinate complex projects ensuring alignment across teams and providing recommendations to leadership for operational efficiency improvements.
- Conduct high-level analysis to identify emerging trends and opportunities for improvement within Managed Care Operations.
- Lead the creation and execution of advanced reporting and dashboard tools to track KPIs and drive continuous operational improvements.
- Partner with Population Health Analytics to ensure the alignment of data analytics and managed care reporting across markets.
Job Requirements
Minimum Qualifications:
- 5 years of experience in business analysis within managed care operations including hands-on experience in one or more of the following areas: contracting claims management UM or care coordination.
- Bachelors degree or 5 years of equivalent work experience in any of the following environments; healthcare administration managed care business information technology or related fields.
- Advanced proficiency in data analysis tools (e.g. SQL PowerBI Excel).
- Proven track record of leading complex projects developing data-driven strategies and driving operational efficiency.
- Strong experience in stakeholder management reporting and performance monitoring within managed care environments.
- Strong analytical and problem-solving skills with the ability to interpret complex data sets and identify key trends.
- Ability to effectively communicate with stakeholders at all levels translating technical findings into actionable business insights.
- Demonstrated ability to collaborate across functions to deliver operational improvements and strategic initiatives.
- Familiarity with HIPAA regulations and data governance best practices.
Preferred Qualifications:
- Masters degree in computer science mathematics management information systems or a closely related field preferred.
- Experience in leading cross-functional teams within managed care operations with a focus on strategic project management and process optimization preferred.
- Advanced knowledge of data governance data integration and reporting systems within the context of managed care preferred.
- Strong familiarity with healthcare data standards (e.g. HIPAA compliance EDI transactions 837/834 files) and managed care systems (e.g. EZCAP Qnxt ImageNet) preferred.
- Proven ability to translate business needs into technical solutions working closely with IT teams to drive system improvements and enhance optional performance preferred.
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Required Experience:
IC
Employment Type
Unclear
