Business Analyst II

McLaren Health Care • Flint, MI

1d

About The Position

McLaren Health Plan (MHP) is a high-performance company focused on helping people live healthier lives. They are seeking a Business Analyst II to contribute to leading the organization forward. MHP is a Managed Care Organization, accredited by the National Committee for Quality Assurance (NCQA), that provides various product lines including individual, family, Medicaid, and Medicare plans to Michigan residents. The company values its employees and fosters an open, cooperative, and dynamic environment, considering all employees as leaders in driving the organization and delivering quality service. The Business Analyst II, under the direction of assigned leadership, is responsible for interpreting business rules, preparing functional specifications for all information systems (including benefits and pricing for claims processing), and developing and maintaining various reports (financial, management, standard production, customer, regulatory, and ad hoc). This role also involves assisting in the enforcement of product, reporting, and service controls, defining test conditions, creating test plans, conducting tests to ensure requirements are met, managing change for systems and reports, coordinating routine maintenance and upgrades, and monitoring system/report performance to identify deficiencies and recommend increased functionality.

Requirements

• Bachelor’s degree in business, computer science, health care or related field; or Associate degree/IT certification and two (2) years related experience; or High School diploma and four (4) years’ related experience.
• Two (2) years’ experience in analytic role utilizing systems and data.

Nice To Haves

• Five (5) years’ experience in computer applications and/or database administration.
• Three (3) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).
• Ability to apply accounting, mathematical and statistical principles to assigned tasks.
• Demonstrated ability to create, modify and design SQL databases.

Responsibilities

• Interprets business rules and prepares functional specifications for all information systems, including benefits and pricing requirements for claims processing systems.
• Develops and maintains financial, management, standard production, customer, regulatory and ad hoc reports.
• Assists in the enforcement of product, reporting and service controls and standards, deadlines, and schedules by creating and maintaining detailed development plans.
• Defines test conditions, creates test plans, and conducts tests to ensure business and reporting requirements are met.
• Responsible for change management of above systems and reports and coordinates all routine maintenance and upgrades.
• Monitors performance of such systems and reports and informs leadership of deficiencies and/or makes recommendations for increased functionality.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level