BUSINESS PROCESS ANALYST 2
About The Position
Business Process Analysts apply an in-depth knowledge of the agency's program areas to define and implement a solution to a given problem that requires an individually tailored response for end-user requirements. Under limited supervision, incumbents perform the full range of journey level duties described in the series concept. Incumbents may serve as a leadworker as assigned. The Silver State Health Insurance Exchange (SSHIX), operating under the Division of Consumer Health Services and the Nevada Health Authority, is hiring for a Business Process Analyst II located in Carson City. This position will serve as the Reconciliation Specialist Lead and, under the general direction of the Information Systems Manager, will oversee the transfer and reconciliation of health and dental enrollment data between the Exchange and its insurance carrier partners. Responsibilities include strategic planning and execution of various data reconciliation programs, along with the development and implementation of policies that guide the reconciliation teams operations. Key duties include investigating discrepancies in enrollment data and collaborating directly with insurance carriers and the Centers for Medicare & Medicaid Services (CMS) to identify and evaluate opportunities for business process improvements that enhance the overall integrity of electronic data interchange. A core function of this role is to facilitate regularly scheduled meetings with the data reconciliation teams of participating insurance carriers. This position will also be responsible for designing, testing, and monitoring enhancements to business processes, while providing technical assistance and training to external partners, carriers, and government agencies. These initiatives must be implemented with minimal disruption to existing systems and workflows. As a project lead, this position will define and manage project scope and objectives, oversee quality assurance for reconciliation programs, and consult with vendor and carrier programmers regarding technical specifications, logic, and system deficiencies. Additionally, this role will provide recommendations on policies and procedures to senior leadership and the Board of Directors. THIS RECRUITMENT MAY CLOSE WITHOUT FURTHER NOTICE DEPENDING ON THE NUMBER OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE
Responsibilities
- Oversee the transfer and reconciliation of health and dental enrollment data between the Exchange and its insurance carrier partners.
- Strategic planning and execution of various data reconciliation programs.
- Development and implementation of policies that guide the reconciliation teams operations.
- Investigating discrepancies in enrollment data and collaborating directly with insurance carriers and the Centers for Medicare & Medicaid Services (CMS) to identify and evaluate opportunities for business process improvements that enhance the overall integrity of electronic data interchange.
- Facilitate regularly scheduled meetings with the data reconciliation teams of participating insurance carriers.
- Designing, testing, and monitoring enhancements to business processes, while providing technical assistance and training to external partners, carriers, and government agencies.
- Define and manage project scope and objectives.
- Oversee quality assurance for reconciliation programs.
- Consult with vendor and carrier programmers regarding technical specifications, logic, and system deficiencies.
- Provide recommendations on policies and procedures to senior leadership and the Board of Directors.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Executive, Legislative, and Other General Government Support
Education Level
No Education Listed
Number of Employees
11-50 employees
