Operations Business Analyst IV
About The Position
The Operations Business Analyst IV oversees business analysis initiatives to drive operational excellence and efficiency of existing processes and systems. This role leads cross-functional process improvements and aligns solutions with organizational strategy. The analyst is responsible for managing and maintaining the policy and performance of claim lifecycle and implementation activities, advising executive leadership on change management strategies, and performing cost-benefit and return on investment analyses for proposed initiatives. They also ensure operational effectiveness by assisting in strategic and business planning, recognizing and managing scope and expected benefits, and performing operational readiness processes. Additionally, this role involves reviewing reports and data for pattern identification, developing and performing testing and validation, and mentoring junior analysts.
Requirements
- Bachelor’s degree in business administration, healthcare management, a related field or equivalent years of relevant work experience is required.
- Seven (7) years of health care operations experience in insurance, managed care, or related industry is required.
- In-depth knowledge of regulatory reporting and compliance requirements.
- Ability to effectively interact with all levels of management within the organization and across multiple organizational layers.
- Demonstrates excellent analysis and collaboration skills.
- Ability to multi-task and juggle competing priorities.
- Exceptional communication (verbal and written), facilitation and presentation skills.
- Strong interpersonal, leadership and relationship building skills.
- Critical listening and thinking skills.
- Customer service oriented.
- Effective time management and prioritization skills.
- Decision making and problem solving skills.
Nice To Haves
- Six Sigma or other performance improvement experience is preferred.
Responsibilities
- Oversee business analysis initiatives to drive operational excellence and efficiency of existing processes and systems.
- Lead cross-functional process improvements and align solutions with organizational strategy.
- Assist in defining and implementing best practices for business analysis, ensuring alignment with enterprise architecture and long-term organizational goals.
- Lead end-to-end process redesign initiatives, including feasibility studies, cost-benefit analyses, and ROI assessments to prioritize high-value projects.
- Participate in the development of operational readiness frameworks for seamless implementation of new systems/processes, including policy documentation and post-launch performance tracking.
- Act as the primary liaison between stakeholders, technical teams, and executive leadership to deliver high-impact outcomes.
- Manage and maintain policy and performance of claim lifecycle and implementation activities to ensure performance objectives are met, including issue tracking and resolution.
- Advise executive leadership on change management strategies, ensuring initiatives align with business objectives and regulatory requirements.
- Perform cost-benefit and return on investment analyses for proposed initiatives to aid decision-making process.
- Collect and analyze data in support of business case creation and realization.
- Ensure operational effectiveness by assisting in strategic and business planning, including business, financial, and operational goals and objectives definition, as well as feasibility studies.
- Recognize and proactively manage scope and expected benefits across the organization’s strategic initiatives and process improvements.
- Perform operational readiness processes and associated documentation, which may include creating, reviewing, revising, and enforcing company and department policies and procedures.
- Take a leading role in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information.
- Develop, document, and perform testing and validation as needed.
- Mentor Business Operations Analyst/Associates to achieve cross-functional capability with project execution and subject matter expertise.
- Perform any other job duties as requested.
Benefits
- Substantial and comprehensive total rewards package.
- May qualify for a bonus tied to company and individual performance.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
