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Healthcare Business Analyst / Data Analyst

DATAMAXIS

Healthcare Business Analyst / Data Analyst

Springfield, IL
Full Time
Paid
  • Responsibilities

    RATE: Depends on Experience Level II = 7+ years of experience in the role

    hybrid work schedule, 2 days a week onsite with occasional 1 hour meetings in person

    PRIMARY RESPONSIBILITIES:

    • Analysis of current business processes and systems, and documenting requirements for new processes and systems

    • Work with internal team and customer on business documentation and updates

    • Attend meetings with user groups and document meeting minutes, action items, and decisions.

    • Assist with user acceptance testing, including defect reporting and follow up. Help with development of test scenarios and acceptance criteria

    • Help with developing presentations for internal team or for the customer. Solicit input from others and pull information together to create a professional presentation.

    • Work with team to document updates needed for Operations Guide

    • Assist with analysis of Medicaid enrollment, provider and claims data, and document requirements, use cases

    • Assist with identifying and documenting data anomalies and collaborate with cross functional teams for effective resolution

    • Share use cases to data analysts for profiling, review results and infer compliance to Medicaid / CMS processes and guidelines

    • Ability to juggle multiple priorities and ensure availability to questions and clarifications from data analysts

    • Positive attitude and willingness to jump in and help where needed

    REQUIRED QUALIFICATIONS:

    • 5+ years of healthcare business analysis experience supporting business initiatives through data analysis, writing business requirements and user acceptance testing of various systems

    • 4+ years of experience in working with State Medicaid and CHIP agencies

    • Basic understanding of CMS reporting requirements for Medicaid

    • Basic understanding of FFS, Managed Care claim adjudication processes from enrollment to funding/finance

    • Basic understanding of managed care encounters

    • Knowledge of health insurance, HMO and managed care principles including Medicaid and Medicare regulation

    • Knowledge of Affordable Care Act and eligibility

    • Be a self-starter and able to thrive in an environment with little guidance

    • Strong time management and organizational skills

    • Excellent interpersonal, oral, and written communication skills

    • Experience with facilitating meetings

    • Proficient with MS Word, MS Excel

    • Effective organizational, analytical, time management, problem-solving, and multi-tasking skills, and habits; ability to complete assignments under tight deadlines with little/no direct supervision

    • Bachelor's degree in related field

    PREFERRED QUALIFICATIONS:

    • Experience working with PERM, T-MSIS, CMS Federal Reporting or similar projects

    • Experience in HEDIS, CHIPRA or similar quality metrics

    • Knowledge of Quality of Care program

    • Ability to perform some data analysis using SQL, Excel against data warehouses utilizing large datasets

    • Knowledge of data integration, software enhancements/planning and agile methodologies

    • Experience with using Azure DevOps, SharePoint, MS Project, Visio