Welcome to Harbor Health, an entirely new multi-specialty clinic group in Austin, TX.
Business Analyst
Location
United States + 180 moreAll locations: United States, Canada, Brazil, Colombia, Argentina, Chile, Venezuela, Bolivarian Republic Of, Bolivia, Plurinational State Of, Ecuador, French Guiana, Guyana, Paraguay, Peru, Suriname, Uruguay, Mexico, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Dominican Republic, Puerto Rico, Bahamas, Guadeloupe, Haiti, Jamaica, Martinique, Montserrat, United Kingdom, Germany, France, Estonia, Portugal, Hungary, Poland, Ukraine, Romania, Bulgaria, Czech Republic, Slovakia, Belarus, Moldova, Republic Of, Sweden, Greece, Belgium, Italy, Ireland, Switzerland, Netherlands, Finland, Malta, Denmark, Lithuania, Croatia, Spain, Austria, Bosnia And Herzegovina, Iceland, Luxembourg, Macedonia, The Former Yugoslav Republic Of, Montenegro, Norway, Serbia, Slovenia, Albania, Cyprus, Latvia, Monaco, South Africa, Egypt, Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Côte D'ivoire, Congo, The Democratic Republic Of The, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-bissau, Kenya, Lesotho, Liberia, Libyan Arab Jamahiriya, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mayotte, Morocco, Mozambique, Namibia, Niger, Nigeria, Réunion, Rwanda, Senegal, Seychelles, Sierra Leone, Somalia, Sudan, Swaziland, Tanzania, United Republic Of, Togo, Tunisia, Uganda, Zambia, Zimbabwe, Georgia, Turkey, Israel, United Arab Emirates, Armenia, Azerbaijan, Bahrain, Iraq, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Palestinian Territory, Occupied, Yemen, India, Japan, Philippines, Pakistan, Thailand, Singapore, Viet Nam, Taiwan, Province Of China, Indonesia, Cambodia, Lao People's Democratic Republic, Malaysia, Myanmar, Korea, Republic Of, China, Afghanistan, Bangladesh, Bhutan, Kazakhstan, Kyrgyzstan, Maldives, Mongolia, Nepal, Sri Lanka, Tajikistan, Turkmenistan, Uzbekistan, Australia, Papua New Guinea, Kiribati, Palau, French Polynesia, Tuvalu, New Zealand
Posted
9 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
The Business Analyst, Health Plan Systems position drives business requirements, process improvements and system enhancements. Uses advanced knowledge of healthcare data, systems, and operational processes to serve as subject matter experts to support health plan growth and improvement initiatives for member enrollment and member/group billing.
- Leads and drives operational performance improvement initiatives.
- Develops, reviews, and approves business requirement documents on assigned subject matter.
- Develops test cases across multiple domains and performs/validates test cases during UAT. Documents and issues for associated vendors.
- Serves as subject matter expert in support of enrollment and member/group billing systems.
- Engages with IT, health plans, and vendor partners to resolve issues and optimize encounters performance.
- Performs root cause analysis of enrollment and member/group billing processing.
- Develop recommendations based on data and industry knowledge. Collaborates across departments to design and implement systems changes to ensure members and group high level of satisfaction.
- Analyzes data to verify outcomes of initiatives.
- Develop reports and distribute them to appropriate departments for error resolution, follow up, and performance monitoring.
- Monitors vendors enrollment and billing processes, contractual compliance, and SLAs.
- Work with the TPA to develop business specs at the start of a technical project.
- Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work.
- Develops detailed knowledge of the functionality of the system used for enrollment and billing ACA/IFP members.
Qualifications
- Three or more years of experience in member enrollment and member/group along with data analysis.
- 3+ years of managed care experience.
- Expert knowledge of healthcare member and billing data.
- Strong data analysis skills and experience writing basic to advanced SQL.
- Strong interpersonal and communication skills.
- Proficient with verbal and written presentation of complex operational information.
- Prior experience in developing RFIs for vendor selection.
- Knowledgeable with CMS requirements around IFP/ACA business.
- 2+ years’ experience in developing test cases and performing UAT.
- 3+ years of IFP/ACA enrollment requirements.
- Significant working knowledge of IFP/ACA enrollment systems (i.e., Health Sherpa).
- Previous experience with the HIPAA 834 and understanding of the transaction’s syntax.
Requirements
- Familiarity with Texas Department of Insurance (TDI) rules, regulations, and law.
- Experience in the Start Up phase of a health plan.
- Strong Excel and Power Point background.
- Background in vendor implementations.
- Experience in bringing an IFP/ACA product to market.
Benefits
- Opportunity to shape, develop and mentor individuals to grow their career and impact their lives.
- Collaborative and dynamic work environment.
- An organization made up of people who are passionate about changing the healthcare landscape.
- Competitive salary and benefits package.
- Professional development and growth opportunities.
- A transparent and unique culture.
Job Requirements
- Three or more years of experience in member enrollment and member/group along with data analysis.
- 3+ years of managed care experience.
- Expert knowledge of healthcare member and billing data.
- Strong data analysis skills and experience writing basic to advanced SQL.
- Strong interpersonal and communication skills.
- Proficient with verbal and written presentation of complex operational information.
- Prior experience in developing RFIs for vendor selection.
- Knowledgeable with CMS requirements around IFP/ACA business.
- 2+ years’ experience in developing test cases and performing UAT.
- 3+ years of IFP/ACA enrollment requirements.
- Significant working knowledge of IFP/ACA enrollment systems (i.e., Health Sherpa).
- Previous experience with the HIPAA 834 and understanding of the transaction’s syntax.
- Familiarity with Texas Department of Insurance (TDI) rules, regulations, and law.
- Experience in the Start Up phase of a health plan.
- Strong Excel and Power Point background.
- Background in vendor implementations.
- Experience in bringing an IFP/ACA product to market.
Benefits
- Opportunity to shape, develop and mentor individuals to grow their career and impact their lives.
- Collaborative and dynamic work environment.
- An organization made up of people who are passionate about changing the healthcare landscape.
- Competitive salary and benefits package.
- Professional development and growth opportunities.
- A transparent and unique culture.
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