Senior Business Analyst
1 month ago
Required Qualifications -
- Outbound Encounters Submissions: expert knowledge of X12 format to include 837, 999 and 277 files.
- Professional experience in the managed care, healthcare, Medicaid or other health insurance industries.
- Experience in Healthcare claims operations and/or encounter submissions preferred.
- Experience in a data warehouse environment and with data warehouse appliances.
- Requires strong expertise in MS Excel and working with SQL Server relational databases.
- Possesses strong analytical and problem-solving skills, with experience working as a liaison between technical and non-technical groups.
- Excellent verbal and written communication skills while sharing complex healthcare analytic data.
- Ability to forge effective business relationships across organizations, functional groups and levels.
- Develops and documents workflow, systems requirements, system impact analysis, systems design, process analysis and testing (including reasonableness checks) using software development methodology to provide efficient, cost-effective solutions as directed.
- Identifies impact of solutions on existing and future systems. May perform operational activities.
- Creates and maintains standard related reports to support operational and development needs.
- Manages reporting and requests for ad hoc reports to support sales, implementation, new product development, specials.
- Queries data warehouse and internal databases and prepares user friendly reports according to outlined requirements.
- Creates and maintains internal management tools and databases to support CQI, rates, workflow business rules and system configuration, reimbursement and document management requirements.
- Develops and maintains project plans.
- Manages small to medium sized projects, system enhancements impacting data management.
- Conducts root cause analyses, gathering data to pinpoint problem areas on which to focus, validating that the analysis is data driven, recommending and implementing solutions and evaluating those results, and implementing controls to monitor consistent use of the solution.
- Participates in design plans for implementation, produces user documentation and training materials. May conduct end user training.
- Provides status reports that give a detailed description of the current project?s progress and indicates time devoted to each task of the project; leads status meetings, creating agendas and documenting meeting minutes as needed.
- Identifies reporting needs based on system configuration and workflows and documents reporting requirements and testing of new reports in development prior to implementation to Production.
- Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the integration of data/other applications into existing systems.
- Performs other duties as assigned.
Other Job Requirements
Responsibilities
5+ years of experience in analysis.Related professional experience in the managed care, healthcare, or insurance industries.
Analytical/problem solving skills, excellent verbal and written communication skills, strong PC background, efficient in using standard software.
Knowledge of system process analysis and/or program management, estimating IT system development and testing.
For positions supporting Medicare, requires 3+ years of experience working in Medicare Operations.
General Job Information
Title
Senior Business Analyst - Encounter OperationsGrade
26Work Experience - Required
Business AnalysisWork Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelor'sEducation - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$70,715Salary Maximum:
$113,145This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
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