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Business Analyst

Tempe, AZ · Healthcare
Managed Care Analytics

(Employee must work on site)
 
Serve as the SME for this medical management area.
**** This is not an IT or Data heavy role – need the expert clinical knowledge.
 
  • Perform and lead various analysis and interpretation to link business needs and objectives and implement process improvements.
  •  Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
  •  Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes
  • Resolve issues and identify opportunities for process redesign and improvement
  • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements.
  • Evaluate risks and concerns and communicate to management.
  • Coordinate with various business units and departments in the development and delivery of training programs.
  • Develop, share, and incorporate organizational best practices into business applications.
  • Oversee all changes to departmental policies and procedures, including communicating and implementing the changes.
  • Serve as the SME on the assigned function product to ensure operational performance.
 
Qualifications:
 
Must Have great rounded knowledge Managed Care and Clinical knowledge
(UM, Prior Authorization, Claims, Billing, Coding, G&A, HEDIS)
6+ years of business process or data analysis preferably in healthcare or five plus years of HEDIS analysis.
SQL experience is a must (but 2nd to Clinical and Managed care)
Bachelor’s degree in related field or equivalent experience. 
 
Preferred Skills:
Advanced knowledge of Microsoft Applications, including Excel and Access preferred and
Project Management experience preferred.
 
 
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