Operations Analyst II

Centene

260d • $55,000 - $99,000

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Under direct supervision, the Operations Analyst II researches and analyzes enrollment data and/or business processes to develop and implement process improvements while acquiring a more advanced skill set for designing and implementing strategic solutions. Interfaces with internal associates and external resources, including Subcontractors and Government entities, to gather information and implement solutions. Participates in projects to identify and document business requirements, implement new technology, research and resolve business issues, and plan and develop systems implementation tactics, including project and test plan input. Gathers, evaluates, interprets, and analyzes data and business processes, or develops test scenarios to evaluate system defects. Presents information, recommendations and alternatives to facilitate management understanding of results and impact. Produces reports or file extracts for data analysis. Evaluates Enrollment department policies and procedures and recommends changes to improve the overall productivity and quality of department systems. Identifies opportunities to improve system processes and recommend changes to streamline operations and/or automate manual processes. At times, may assume responsibility for data integrity among various internal groups and/or between internal and external sources. Participates in projects that contribute to achievement of department objectives. Projects will be completed on-time, within budget, and according to established objectives and documented requirements. Participates in developing project plans, test plans, implementation strategies, and post implementation plans. Provides business function support for system upgrades and Government-mandated change orders. Prepares status reports and/or issue resolution to internal associates and/or external resources. Participates in developing and reviewing business system requirements and scope and design documents. Troubleshoots user-reported system defects and educates users on issues that are not true-system defects. Analyzes true defects and follows up with applicable subcontractor to resolve. Performs other duties as assigned. Complies with all policies and standards.

Requirements

• High School Diploma or equivalent.
• Experience in researching and analyzing data for process improvement preferred.
• Two years health plan or health insurance operations experience.
• Experience in Enrollment, billing and/or claims processing preferred.

Responsibilities

• Research and analyze enrollment data and/or business processes.
• Develop and implement process improvements.
• Interface with internal associates and external resources.
• Participate in projects to identify and document business requirements.
• Implement new technology and research business issues.
• Plan and develop systems implementation tactics.
• Gather, evaluate, interpret, and analyze data and business processes.
• Develop test scenarios to evaluate system defects.
• Present information, recommendations, and alternatives to management.
• Produce reports or file extracts for data analysis.
• Evaluate Enrollment department policies and procedures.
• Recommend changes to improve productivity and quality.
• Identify opportunities to improve system processes.
• Assume responsibility for data integrity among internal and external sources.
• Participate in projects contributing to department objectives.
• Develop project plans, test plans, and implementation strategies.
• Provide business function support for system upgrades.
• Prepare status reports and issue resolutions.
• Develop and review business system requirements and design documents.
• Troubleshoot user-reported system defects.
• Analyze true defects and follow up with subcontractors.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED