Business Systems Analyst

Do you have experience applying data systems expertise to operationalize policies and programs that seek to ensure equitable access and high quality health care services and supports? Are you enthusiastic about analyzing data to create solutions and ensuring the efficiency of information systems through research and data testing for Oregon Health Plan members? We look forward to hearing from you

to view a Dashboard of all current recruitments for the Behavioral Health Division, Medicaid Division, and the Office of Data Strategy & Operations (which were previously all part of ). The specific positions associated with this posting are listed under REQ-157569. The dashboard identifies the business area (“Section”) and Unit for each position and also provides a link to a position description to offer you greater context for the role. Section 1 of the position description outlines Position Information, including Work Location and Supervisor Name. Section 3 outlines the Description of Duties. In some circumstances, a position summary will be posted; selected candidates will be provided the full position description at time of hire.

This posting will be used to fill one (1) full-time position. The position is classified and is represented by a union. 

Work Location: Salem/Marion; hybrid position

What you will do

This position serves as a business analyst focused on identification, solution design and resolution of Medicaid claims-related work within the Medicaid Management Information System (MMIS). This position will focus on issues related to claims adjudication within the MMIS, including research of claims and how they are processing within the system. Additionally, this position will be responsible for testing change requests for the MMIS that have a claims subsystem impact.

This position also participates and collaborates with multiple business partners across the Oregon Health Authority (OHA), Oregon Department of Human Services (ODHS) and various shared services programs to find resolution for outstanding claims issues.  This position requires thorough research and identification of various claim types in the MMIS and will also at times advise agency leadership and business partners of recommended changes or direction that help to meet the expectations of the agency in serving Oregonians who receive Medicaid services. This position also requires knowledge of both state and federal rules regarding Medicaid claims payments and all stages of Medicaid claims processing.

The position also has responsibility to give oversight and collaborative work in the Electronic Data Management System (EDMS). This position will also work in a cross-collaboration manner to help address other MMIS system issues and impacts, as needed. The claims business systems analyst serves as part of the Business Information Systems Section and specifically within the MMIS Business Services Unit.

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

The OHA mission is helping people and communities achieve optimum physical, mental, and social well-being through partnership, prevention and access to quality, affordable health care. OHA’s work is organized into three broad goals: Improve the lifelong health of all Oregonians, increase the quality, reliability, and availability of care for all Oregonians and lower or contain the cost of care so it is affordable to everyone.

What's in it for you?
Oregon Health Authority is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities. We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace.

• We offer exceptional benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs. Try this free virtual benefits counselor by clicking here:  
• Paid Leave Days:
  • 11 paid holidays each year
  • 3 additional paid "Personal Business Days" each year
  • 8 hours of paid sick leave accumulated every month
  • Progressive vacation leave accrual with increases every 5 years
• Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Click to learn more about State of Oregon benefits.

OHA values health equity, service excellence, integrity, leadership, partnership, innovation and transparency. OHA’s health equity definition is “Oregon will have established a health system that creates health equity when all people can reach their full potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances. Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address: the equitable distribution or redistributing of resources and power; and recognizing, reconciling, and rectifying historical and contemporary injustices.” OHA’s 10-year goal is to eliminate health inequities. Click , to learn more about OHA’s mission, vision and core values.

WHAT WE ARE LOOKING FOR:

Minimum Qualifications

Any combination of experience and education equivalent to five years professional-level evaluative, analytical and planning work.

Example: A Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or any degree demonstrating the capacity for the knowledge and skills; and two years professional-level evaluative, analytical and planning work.

Desired Attributes

• Evidence of ongoing development of personal cultural awareness and humility, and knowledge of social determinants of health and their impacts on health outcomes.
• Experience developing, implementing policies and programs at the community, state, and/or national level that promote equity and inclusion and address systemic health disparities, with an emphasis on integrating the voice of consumers with lived experience.
• Experience factoring in the perspectives of diverse populations most harmed by social injustice and inequities including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA+ and other communities that have been traditionally marginalized.
• Specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes, other applicable regulations, and program requirements.
• Knowledge of health services delivery systems, particularly the Oregon Health Plan/ Medicaid administration in Oregon, and experience in working with Community Mental Health Programs, Behavioral Health Service Providers, Coordinated Care Organizations or other managed care entities.
• Knowledge of the Medical Assistance program policies and procedures.
• Knowledge of Medicaid Management Information System (MMIS) relevant functions, processes, and interfaces.
• Knowledge of information systems development and implementation processes.
• Knowledge of quality improvement methodologies and metrics within the context of health policy, health systems, and health care delivery settings.
• Strong communication skills across a variety of forms that demonstrate the ability to facilitate appreciative inquiry, foster trust and transparency, and promote human-centered change management.
• Ability to navigate complex relationships; ability to demonstrate collaborative problem-solving skills, consensus-building and solution driven approaches. 
• Ability to demonstrate advanced Microsoft Excel, Word, PowerPoint and Outlook skillset; and skilled use of collaboration tools such as Microsoft Teams, SharePoint, and Smartsheet.
• Demonstrates skills in the following areas:
  • Constructive and Collaborative Working Relationships
  • Issue Identification and Resolution
  • Performance / Process / Quality Improvement
  • Data Management and Mapping
  • Workload Planning & Prioritization
  • Project Planning and Prioritization
  • Expert level Technical Assistance
  • Strong Oral and Written Communication