Health Analyst Jobs

About The Position

Requirements

• Bachelor’s degree in business or a healthcare-related field; equivalent education and/or experience may be considered in lieu of a degree.
• At least 5 years of experience in a systems configuration, claims, or other operations department in a healthcare organization.
• Advanced knowledge of and experience with health plan configuration, especially for health services, medical management, population health management, and appeals and grievances systems and applications.
• Knowledge of and experience using Milliman care guidelines (MCGs) and standards.
• Knowledge of and experience with SDLC and related configuration change management methodologies, standards, and best practices.
• Advanced understanding of managed care operations, including health services, medical management, population health management, and appeals and grievances, and the systems that support these operations.
• Knowledge of Systems Development Life Cycle (SDLC) procedures in planning system configuration.
• Strong communication, analytical, organizational, and time-management skills.
• Ability to manage projects and initiatives end-to-end.
• Ability to meet strict, tight deadlines with a high level of accuracy.
• Ability to prioritize multiple tasks.
• Ability to work collaboratively with peers and management at various levels throughout the organization.

Nice To Haves

• At least 5 years of experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.

Responsibilities

• Manage complex surround systems configuration and related documentation.
• Serve as a subject matter expert for configuration change management testing and related best practices.
• Facilitate production controls and system configuration data codification.
• Monitor and review system edits and response-time issues; conduct advanced root-cause analysis and recommend resolutions.
• Identify and facilitate implementation of system and process improvements and best practices.
• Collaborate across and outside the department and organization on configuration management practices, system enhancements, system configuration life-cycle plans, and tracking and resolving operational issues.
• Perform peer reviews for staff at all levels and ensure the quality of work products.
• Evaluate business operations and processes and identify where technical solutions could improve performance.
• Ensure project and program deliverables meet departmental and organizational needs and applicable legislation, policies, standards, and best practices.
• Provide training, recommend process improvements, and mentor junior staff and department interns as needed.
• Provide recommendations for vendor enhancements to surround systems products.
• Perform other duties as assigned.

Benefits

• Paid Time Off (PTO)
• Tuition reimbursement
• Retirement plans
• Medical insurance
• Dental insurance
• Vision insurance
• Wellness program
• Volunteer Time Off (VTO)