Business Operations Analyst
About The Position
The Business Operations Analyst provides support to the Network Provider Operations department with daily operations, project initiatives, system updates, special projects, and all regulatory reporting and analysis. The Analyst will audit departmental operations with a focus on data integrity, improving accuracy, and identifying training opportunities for the department. Responsible for preparation and submission of all Provider Network Regulatory Reporting. Develop and run extracts to support departmental operational reporting. Lead system upgrades and implementations for the department, and provide technical support as needed. Collaborate with existing technical EPIS structure.
Requirements
- High school diploma
- 3-5 years of experience in a managed care environment
- Experience with working with technology, systems, provider and/or claims data
- Experience with data, trending, and qualitative analysis
- Familiarity with Medicaid and Medicare regulations
- Experience with geo access analysis and regulatory reporting
- Experience with generating files and reviewing quality for provider directories
- Microsoft Word, Excel, Access, and Visio.
- SQL.
- Knowledge of provider data entry and credentialing process
- Ability to utilize Access and SQL to program and execute queries to support data structure and analysis, including tracking and trending on errors
- Excellent verbal and written communication skills
- Ability to evaluate system set-up and files to determine whether changes are needed to process correctly
- Ability to handle multiple deliverables and to meet strict reporting timeframes
- Knowledge of NY regulatory reports
Nice To Haves
- Associates Degree or Bachelors Degree in health/business related field preferred
- Visual CACTUS, HealthRules Payor, Quest Analytics, and Optum GeoAccess Suite
Responsibilities
- Provides support to the Network Provider Operations department with daily operations, project initiatives, system updates, special projects, and all regulatory reporting and analysis.
- Audits departmental operations with a focus on data integrity, improving accuracy, and identifying training opportunities for the department.
- Responsible for preparation and submission of all Provider Network Regulatory Reporting.
- Develops and runs extracts to support departmental operational reporting.
- Leads system upgrades and implementations for the department, and provides technical support as needed.
- Collaborates with existing technical EPIS structure.
Benefits
- Tuition Reimbursement for all full and part-time staff
- Generous paid time off, including your birthday!
- Affordable and comprehensive medical, dental and vision coverage for employee and family members
- Two retirement plans! 403(b) AND Employer Paid Pension
- Flexible spending
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
