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Business Analyst - Remote

Open 58d

Daily Responsibilities:

  • Support cross-functional work streams and teams to build and manage programs and projects that directly support HEDIS data quality improvement and reporting
  • Conduct claims data and systems analysis and claims-related business analysis
  • Ensure HEDIS data integrity and process optimization
  • Partner with various lines of business, stakeholders and SMEs to determine impact and solutions
  • Re-mediate gaps in existing production processes that can impact regulatory requirements
  • Conduct research, complete data mining, and other necessary tasks to identify and validate business and HEDIS reporting requirements
  • Perform testing and piloting of new HEDIS reporting processes, solutions and technology
  • Perform root cause analysis of HEDIS data and provide recommendations and/or solutions
  • Document and communicate detailed process documentation to describe processes & reason for changes (to include but not limited to: process mapping, P&Ps, SOPs, and BRDs).
  • Utilize and analyze claims and investigate data to ensure HEDIS data and processes are appropriately followed, managed and reported


Hours:

  • Monday-Friday daytime hours


Advantages of this Opportunity:

  • Competitive salary, negotiable based on relevant experience
  • Benefits offered, Medical, Dental, and Vision
  • Fun and positive work environment



Requirements:

  • BA/BS Degree
  • 4+ years of health plan experience in claims, contracting, or reimbursement
  • 2+ years of experience with coding and reimbursement methodologies and policies
  • 1+ year or data analysis



Are you an experienced Business Analyst looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!


Want More Information?

Interested in hearing more about this great opportunity? Reach out to Amanda Hammer at 407-636-7030x201 or apply to obtain additional details.



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