Business Analyst IV - Implementation Support & UAT (LTSS)

Centene Corporation

1d•Remote

About The Position

Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. This is a remote role. The position's purpose is to perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements. Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems. Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes. Resolve issues and identify opportunities for process redesign and improvement. Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements. Evaluate risks and concerns and communicate to management. Coordinate with various business units and departments in the development and delivery of training programs. Develop, share, and incorporate organizational best practices into business applications. Oversee all changes to departmental policies and procedures, including communicating and implementing the changes. Serve as the subject matter expert on the assigned function product to ensure operational performance. Ability to travel may be required.

Requirements

Bachelor’s degree in related field or equivalent experience.
6+ years of business process or data analysis preferably in healthcare or 5+ years of HEDIS analysis.
Advanced knowledge of Microsoft Applications, including Excel and Access preferred.
Project management experience preferred.
Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies.
Knowledge of managed care information or claims payment systems preferred.
Previous structured testing experience preferred.
Experience in healthcare industry, preferably with managed care techniques and administrative philosophy.
Experience in claims coding analysis or medical claim review/research preferred.
Knowledge of Amisys claims payment system and Business Objects preferred.
6+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 5+ years of managed care encounters experience.
Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid.
Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred.
6+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry and/or working in a data driven environment.
Knowledge of data migration, software enhancement/planning, and Agile required.
Experience managing large projects with a high reliance on technology.
6+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry and/or customer service or enrollment functions.
Experience managing projects with a high reliance on technology.
Knowledge of data integration, software enhancements/planning and Agile preferred.
6+ years of business process or data analysis experience, including business process definition and documentation and agile development, preferably in healthcare working in a data driven environment.
Experience managing large projects with a high reliance on technology.
Project management experience preferred.
Experience in claims and knowledge of risk adjusted revenue, member quality and provider reimbursement methodologies preferred.
Knowledge of managed care information or claims payment systems preferred.
Previous structured testing experience preferred.
Product Management and SQL experience preferred.
6+ years of business process analysis, deep understanding of managed care/utilization management data including sourcing, analysis and representation of data, understanding of and experience in clinical documentation platforms.
Highly preferred that candidate has experience in Business Analysis, UAT, or Quality roles, as well as supporting integration testing and data/interface validation.
Experience leading UAT execution, defect management, and readiness reporting.
Proficient in Azure DevOps, JIRA, or ServiceNow with strong facilitation and influencing skills.

Nice To Haves

LTSS processes knowledge preferred
TruCare Classic and TruCare Cloud experience strongly desired
Care Central/Facets a plus
Advanced knowledge of Microsoft Applications, including Excel, Project, and Visio preferred.
Product Management and SQL experience preferred.
Advanced knowledge of Microsoft Applications, including Excel and Visio preferred.
Advanced knowledge of Microsoft Applications, including Excel, Access and Visio preferred.

Responsibilities

Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements.
Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes
Resolve issues and identify opportunities for process redesign and improvement
Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements
Evaluate risks and concerns and communicate to management
Coordinate with various business units and departments in the development and delivery of training programs
Develop, share, and incorporate organizational best practices into business applications
Oversee all changes to departmental policies and procedures, including communicating and implementing the changes
Serve as the subject matter expert on the assigned function product to ensure operational performance
Ability to travel