Business Professional

Found in: beBee jobs US - 3 weeks ago

Long Beach, California, United States Mitchell Martin Inc Full time
Our Client, a managed care company, is seeking an Business Professional - Business Analyst III

Location: Long Beach, CA

Position Type: Contract

Job Responsibilities:
  • Able to review, understand different types of Provider Contracts
  • Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers
  • Identifies and interprets trends and patterns in datasets to locate influences
  • Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge
  • Creates specifications for reports and analysis based on business needs and required or available data elements
  • Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs
  • May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action
  • This is a general role in which employees work with multiple types of business data
  • Elicit requirements using interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis
  • Interpret customer business needs and translate them into application and operational requirements
  • Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed
  • Work with operational leaders within the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements
  • Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials and other related documentations
  • Actively participates in all stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and operational requirements
Skills:
  • 5+ years related experience in Healthcare Payor domain with a focus on Provider Network Management/Provider Contracting
  • Demonstrated competency related to Provider contract implementation preferably with CA Medicaid
  • Proficiency in analyzing and understanding contract terms, payment structures, reimbursement methodologies, network adequacy.
  • Candidates with QNXT, CAD, or CONGA would be preferred but not required.
Education & Experience:
  • Bachelor's degree. Emphasis in business operations/management preferred.
  • Will accept experience in lieu of formal education.
  • Minimum of 5-7 years proven analytical experience.

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