Job Description

Description

As a member of the Medicare Advantage Operations
team, Business Data Analyst is instrumental in independently developing the
detailed requirements specifications according to business needs. 

In this role, you will:

• work directly
  with and serve as the liaison between business units, external trading
  partners, IT teams and support teams
• ensure functional and non-functional
  requirements are understood and implemented consistent with the Business Data Analysts
  vision
• perform testing, design and delivery requirements
• work with the team
  to identify, analyze, quantify, and mitigate business risks
• collaborate with
  the 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 $78,600 - $163,600 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.

Qualifications

• Bachelors 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 and
  compliance requirements.
• Experience
  managing vendors to contractual requirements.
• Strong ability
  to research and resolve encounter issues.
• Strong
  knowledge of the health care model, capitation
  and other managed care IPA and provider reimbursement methodologies.
• Strong knowledge of physician and facility billing
  practices, appropriate CPT coding initiatives, ICD-10 coding standards, as well
  as Revenue and HCPCS coding.
• Strong
  leadership skills, with the ability to articulate goals,
  plan and implement processes to achieve those goals, recognize and assess the
  implications of confounding variables, anticipate consequences, and meet
  deadlines.
• Demonstrated ability to analyze and organize
  complex federal and private insurance regulations.
• Working knowledge of Microsoft Office
  Suite (Excel, Word, and PowerPoint) and data visualization tools.
• Skill in prioritizing and performing a variety of
  duties within a system that has frequently changing assignments, priorities and
  deadlines.
• Reliability and compliance with scheduling
  standards.
• Strong leadership and interpersonal skills
  
• Initiative, problem identification, resolution
  and analytical skills are essential.
• Excellent oral and written communication skills
  are required.
• Ability to modify and adapt operational
  procedures to changing operational needs
• Strong critical thinking and the ability to apply
  knowledge at a broad level within a complex academic medical center is
  essential.
• Ability to develop, implement, and
  evaluate methods and systems to improve efficiency.
• Proven skills to lead and facilitate
  cross-functional workgroups and other meetings.
• Ability to work as part of a team, collaborating
  with colleagues.
• Ability to analyze and organize complex federal and
  private insurance regulations.
• Must be effective at working
  independently with minimal supervision.
• Ability to support the working hours
  of the department.
• Ability to travel/attend off-site meetings and
  conferences.
• Ability to set and
  manage priorities judiciously
  
• Excellent interpersonal
  skills; demonstrated ability to give and receive constructive feedback
• Ability to articulate
  ideas to both technical and non-technical staff
• Exceptionally
  self-motivated; ability to motivate and participate in a team-oriented,
  collaborative environment.
• Superior analytical and
  problem solving abilities
• Must be customer service
  oriented, be able to work well individually and as part of a team; and have a
  strong work ethic.

Job Tags

Similar Jobs