Senior Business Analyst

2 weeks ago

Wilmington, North Carolina, 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 Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

What you'll do:

  • Plan, design, develop, and launch business, financial and operations reports in support of core organizational functions. Create output that is well organized and easy to understand for the customer.
  • Perform ad-hoc analyses for submission to Claims operations for adjustments.
  • Develop and analyze large data sets to determine root cause and recommend process improvements.
  • Create forward thinking solutions that may involve new applications, interfaces, architectures, processes such as:
    • Claims payment systems, claim software editing systems, provider and member portals, authorization support systems, etc.
  • Test, validate, and perform quality audits on simple and complex algorithms
  • Support Payment Integrity to identify gaps in data and leading efforts to close those gaps.
  • Utilize knowledge of numerous databases, information systems, statistical tools and analytical principles to monitor and analyze information in support of the business.
  • Investigate recovery issues with direct contact with providers

What you'll bring:

  • 5+ years of business experience - managed care contracting, medical billing, claims auditing, claims analysis, and actuarial analysis.
  • Experience with using data visualization applications such as Tableau, Power BI and SSRS
  • Operational knowledge as it relates to operations in claims, customer service and member enrollment.
  • Bachelor's Degree in Business, HealthCare Management or related field preferred. Additional related work experience may substitute for some educational requirements. Master's Degree preferred.

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.

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

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