San Antonio, Texas
Cary, North Carolina
Durham, North Carolina
Raleigh, North Carolina
Durham, North Carolina
Nashville, Tennessee
Posted: 15-Jul-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 140056050
As a member of the Medicare Advantage Operationsteam, Business Data Analyst is instrumental in independently developing thedetailed requirements specifications according to business needs.
In this role, you will:
- work directlywith and serve as the liaison between business units, external tradingpartners, IT teams and support teams
- ensure functional and non-functionalrequirements are understood and implemented consistent with the Business Data Analyst'svision
- perform testing, design and delivery requirements
- work with the teamto identify, analyze, quantify, and mitigate business risks
- collaborate withthe training/development staff to deliver and update training documentation
- generate adhoc reports to support operations team as needed
This is a flex-hybrid role which will require you to be onsite as required by operational need; there are no reimbursements for travel to "home office" location. Each employee must complete a FlexWork Agreement with their manager which will outline arrangement parameters and aids both parties in fully understanding expectations. Arrangements are regularly evaluated, and are subject to termination.
Salary offers are determined based on various factors including, but not limited to, qualifications, experience, and equity. The full salary range for this position is $71,500 - $154,900 annually. The budgeted salary or hourly range that the University reasonably expects to pay for this position is approximately between $80,000 - $113,000 annually.
- Bachelor's Degree in Business Administration, Information Systems, Health Care or other related field required
- Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required
- Minimum of five (5) years' experience with CMS processes in a Medicare or Managed Care environment required
- Experience with CMS processes is a plus
- Knowledge of SQL window based computer environment including MS Office and related programs is a plus
- Knowledge of encounter regulatory reporting andcompliance requirements.
- Experiencemanaging vendors to contractual requirements.
- Strong abilityto research and resolve encounter issues.
- Strongknowledge of the health care model, capitationand other managed care IPA and provider reimbursement methodologies.
- Strong knowledge of physician and facility billingpractices, appropriate CPT coding initiatives, ICD-10 coding standards, as wellas Revenue and HCPCS coding.
- Strongleadership skills, with the ability to articulate goals,plan and implement processes to achieve those goals, recognize and assess theimplications of confounding variables, anticipate consequences, and meetdeadlines.
- Demonstrated ability to analyze and organizecomplex federal and private insurance regulations.
- Working knowledge of Microsoft OfficeSuite (Excel, Word, and PowerPoint) and data visualization tools.
- Skill in prioritizing and performing a variety ofduties within a system that has frequently changing assignments, priorities anddeadlines.
- Reliability and compliance with schedulingstandards.
- Strong leadership and interpersonal skills
- Initiative, problem identification, resolutionand analytical skills are essential.
- Excellent oral and written communication skillsare required.
- Ability to modify and adapt operationalprocedures to changing operational needs
- Strong critical thinking and the ability to applyknowledge at a broad level within a complex academic medical center isessential.
- Ability to develop, implement, andevaluate methods and systems to improve efficiency.
- Proven skills to lead and facilitatecross-functional workgroups and other meetings.
- Ability to work as part of a team, collaboratingwith colleagues.
- Ability to analyze and organize complex federal andprivate insurance regulations.
- Must be effective at workingindependently with minimal supervision.
- Ability to support the working hoursof the department.
- Ability to travel/attend off-site meetings andconferences.
- Ability to set andmanage priorities judiciously
- Excellent interpersonalskills; demonstrated ability to give and receive constructive feedback
- Ability to articulateideas to both technical and non-technical staff
- Exceptionallyself-motivated; ability to motivate and participate in a team-oriented,collaborative environment.
- Superior analytical andproblem solving abilities
- Must be customer serviceoriented, be able to work well individually and as part of a team; and have astrong work ethic.
