Business Analyst

3 weeks ago

Hanover, United States Johns Hopkins Medicine Full time

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

  • Work-life balance - This is a hybrid role requiring you to work 1 day per week in the Hanover, MD office
  • Medical, Dental, and Vision Insurance.
  • 403B Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

As a Business Analyst in Operations, you’ll:

  • Lead JHHP oversight of member and provider data, remediation work and outreach for the Medicare Advantage product.
  • Provide daily oversight of the following provider related items: provider exception report, provider file, utilization management temporary provider remediation process and LOA process. Provide daily/monthly oversight of the following member related items: MMR, TRR, FIR reports, PDE reports, CTM, appeals and grievance trending and member outreach as necessary.
  • Support the Advantage MD and Advantage MD plus programs by providing data analysis, process management, inventory management and documentation support.
    • Documentation includes business design documentation, business requirements and functional specifications and configuration mapping requirements for inbound and outbound file solutions.
  • Communicate in a timely, accurate and professional manner with all internal and external customers.
  • Plan, design, develop, and launch business, financial and operations reports in support of core organizational functions.
  • Develop and analyze large data sets to determine root cause and recommend process improvements.
  • Create/maintain reports and perform analyses for business operations and special projects.

What you’ll bring:

  • 3+ years’ progressively more responsible experience in a managed care environment.
  • Excellent analytical, organizational and interpersonal skills, as well as a strong background in Managed Care preferably Medicare Advantage plans and Medicare regulations.
  • Experience with MAPD enrollment experience within a health plan or related environment.
  • Knowledge of Facets and HEALTHsuite claim payment system is preferred.
  • Intermediate level ability with Excel and Access.
  • Bachelor’s Degree in Business, HealthCare Management or related field preferred. Additional related work experience may substitute for some educational requirements.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

Target Salary Range: Minimum 28.05 per hour - Maximum 41.17 per hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

  • Senior Business Analyst

    1 month ago

    Hanover, United States Prominent Global Solutions Full time

    Job DescriptionJob DescriptionSalary: Summary: The candidate will be responsible for providing  analyses and trade-off studies related to operational issues and reviews test plans to ensure operational requirements. The candidate will work with little to no supervision to plan, conduct, direct, analyze, and interpret information for business, financial,...

  • Business Analyst II

    2 weeks ago

    Hanover, United States Elevance Health Full time

    Anticipated End Date: 2024-08-30 Position Title: Business Analyst II Job Description: Business Analyst II This position will work a hybrid model (remote and office), 1-2 times per week in office. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health...

  • Senior Business/Data Analyst

    2 days ago

    Hanover, United States Iris Software Inc. Full time

    Iris's client, one of the world's largest multinational investment banking and financial services corporation is looking to hire a Business Analyst/Data Analyst for a Long-Term opportunity.Work Location: Whippany, NJ / NYC (Hybrid – 2 to 3 day’s onsite)Job description:Business analysis/Data Analyst with finance domainSome understanding of the technology...

  • Senior Business Analyst

    2 weeks ago

    Hanover, United States Prominent Global Solutions Full time

    Job DescriptionJob DescriptionSalary: Summary: The candidate will be responsible for providing  analyses and trade-off studies related to operational issues and reviews test plans to ensure operational requirements. The candidate will work with little to no supervision to plan, conduct, direct, analyze, and interpret information for business, financial,...

  • Sr Business Data analyst

    2 days ago

    Hanover, United States Iris Software Inc. Full time

    Hi ,I hope you're doing well.We have a great opportunity with one of IRIS's Financial clients in US is looking for the Sr BA/DA(Business Data Analyst) -Capital Market with RISK (Market Risk Preferred) Hybrid Whippany NJ. Please Share your Resume on Rajneesh.bhardwaj01@Irissoftware.comLocal candidate only Should apply Hybrid 2 days from office.Business...

  • Quality Improvement Business Analyst

    3 months ago

    Hanover, United States Johns Hopkins Medicine Full time

    Who you are: As a Business Analyst in Quality Improvement for Johns Hopkins Health Plans, you will work with a team to improve HEDIS measure performance across three lines of business including one Medicaid and two commercial plans. You are detail-oriented and able to maintain focus while working with large sets of data. You have the ability resolve...

  • Quality Improvement Business Analyst

    2 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Who you are: As a Business Analyst in Quality Improvement for Johns Hopkins Health Plans, you will work with a team to improve HEDIS measure performance across three lines of business including one Medicaid and two commercial plans. You are detail-oriented and able to maintain focus while working with large sets of data. You have the ability resolve...

  • Business Analyst, Configuration

    2 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...

  • Business Analyst, Configuration

    3 months ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...

  • CM/UM Business Analyst

    2 months ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...

  • Senior Business Analyst, Utilization Management

    2 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: This is a remote role! Work-life balance Medical, Dental, and Vision Insurance. 403B...

  • Senior Business Analyst, Utilization Management

    3 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: This is a remote role! Work-life balance Medical, Dental, and Vision Insurance. 403B...

  • Lead Business Analyst

    7 days ago

    Hanover Hills, Maryland, United States Prominent Global Solutions Full time

    Job OverviewSalary: CompetitiveSummary: The selected candidate will play a pivotal role in conducting comprehensive analyses and evaluations related to operational challenges. This position requires minimal supervision to effectively plan, execute, analyze, and interpret data for various business, financial, technical, and professional service initiatives....

  • Lead Business Analyst

    2 weeks ago

    Hanover Hills, Maryland, United States Prominent Global Solutions Full time

    Job OverviewSalary: CompetitiveSummary: The selected candidate will take charge of conducting analyses and trade-off assessments related to operational challenges while reviewing test plans to confirm operational needs. This role requires minimal supervision to effectively plan, execute, direct, analyze, and interpret data for business, financial, technical,...

  • Lead Business Analyst

    2 weeks ago

    Hanover Hills, Maryland, United States Prominent Global Solutions Full time

    Job OverviewSalary: CompetitiveSummary: The selected candidate will play a pivotal role in conducting analyses and trade-off assessments concerning operational challenges. They will review testing strategies to ensure that operational requirements are met. The candidate is expected to work independently, planning, executing, directing, analyzing, and...

  • Senior Business Analyst, Utilization Management

    1 month ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: This is a remote role! Work-life balance Medical, Dental, and Vision Insurance. 403B...

  • Technical Business Analyst

    3 months ago

    Hanover, United States PeopleShare Full time

    PeopleShare is seeking a REMOTE Technical Business Analyst for an innovative, industry leading healthcare company! You will play a critical role in the client software development lifecycle, with emphasis on the upfront conception/design of new client programs, client enhancements, and development of new client-driven products.Schedule: Monday – Friday,...

  • Exploitation Analyst

    3 months ago

    Hanover, United States Belay Technologies Full time

    Belay Technologies has been voted Baltimore Business Journal's (BBJ) Best Places to Work 2019, runner up in 2020 and a finalist in 2021! Belay is hiring an Exploitation Analysts (EA) to support a brand new contract! The EA have many of the same skills of Digital Network Exploitation Analyst (DNEA), but their primary mission is more focused on exploitation....

  • Exploitation Analyst

    3 months ago

    Hanover, United States Belay Technologies Full time

    Job DescriptionJob DescriptionBelay Technologies has been voted Baltimore Business Journal's (BBJ) Best Places to Work 2019, runner up in 2020 and a finalist in 2021!Belay is hiring an Exploitation Analysts (EA) to support a brand new contract! The EA have many of the same skills of Digital Network Exploitation Analyst (DNEA), but their primary mission...

  • Pharmacy Business Analyst

    2 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a hybrid role requiring you to work 1 day per week in the Hanover,...