CCA Clinical Ops

CareSource

About The Position

The Clinical Operations Business Analyst is responsible for the development of reports, analytics, and recommendations to ensure continuous process improvement and gap closure. This role reviews policies and regulatory requirements, analyzes data and creates recommendations to improve operational functionality, and leads projects of variable size, scope, and complexity, directly engaging with senior leaders.

Requirements

Bachelor's Degree in information systems or related quantitative field required (Finance, Business, Computer Science, Mathematics, Economics, or similar) required
Equivalent years of relevant work experience may be accepted in lieu of required education
Two (2) years SQL Server programming experience required
Two (2) years of experience with BI products like, Tableau, Alteryx, Looker required
Two (2) years of analytical experience with data or statistical analysis in healthcare industry required
Advanced knowledge of Excel, including use of Pivot tables, and SQL
Strong math and analytical skills
Strong understanding of financial concepts
Ability to establish and maintain positive and effective work relationships with internal staff, external vendors, and state and federal agencies
Proven ability to translate business needs into BI requirements
Proven skills and judgment necessary for independent decision-making
Strong organizational, time-management and problem-solving skills
Ability to work independently and within a team environment
Strong communication skills both written and verbal
Critical listening and thinking skills

Nice To Haves

Experience with robotic process automation (RPA) preferred
Managed care/provider contract modeling experience preferred

Responsibilities

Engages with stakeholders to understand current processes/systems and pain points as well as elicit detailed business needs of/gather requirements for reports and tools
Develops reports by querying the database using SQL or any related programming language and analyzing data to ensure accuracy
Promote new and innovative recommendations to improve accuracy reporting such as robotic process automation (RPA).
Creates visualizations using Tableau, Looker, Excel
Analyzes large sets of data, summarizes, and presents results
Develops and analyzes quantitative and qualitative data to meet compliance and operational needs, supporting different departments such as Assessments, Authorizations, Appeals and Grievances, Claims, etc.
Partners with clinical operations management to develop and review workflows, to streamline processes and increase efficiency.
Generates insights and develops recommendations for solutions
Creates Visio diagrams or other visualizations to use in prototype review sessions
Plays a role in developing and managing major clinical operations analytic projects
Serves as liaison between Business Intelligence team and various departments within Clinical Operations, translating the business needs into BI requirements for reports, dashboards, and tools
Performs any other job related duties as requested.