Job details

Business Analyst II

Job Summary:

The Operations Business Analyst II is responsible for reviewing and analyzing the effectiveness and efficiency of existing managed care claims processes and systems (Facets),and participate in development of solutions to improve or further leverage these functions.

Essential Functions:

Review and analyze the effectiveness and efficiency of existing processes and systems, and participate in development of solutions to improve or further leverage these functions
Perform cost-benefit and return on investment analyses for proposed initiatives to aid decision-making process as well as collect and analyze data in support of business case creation and realization
Ensures operational effectiveness by assisting in strategic and business planning, including business, financial, and operational goals and objectives definition as well as feasibility studies
Recognizes and proactively manages scope and expected benefits across the organization’s strategic initiatives and process improvements
Assists in operational readiness process by reviewing transitional activities and associated documentation for completion prior to initiative implementation, including operational reports, turnover documentation, departmental policies and procedures and job aids
Assist 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
Perform any other job duties as requested

Education and Experience:

Bachelor of Science/Arts degree or equivalent work experience is required
Three to five (3-5) years of health care operations experience in health insurance, managed care, or related industry is preferred

Competencies, Knowledge and Skills:

Knowledge of regulatory reporting and compliance requirements
Both claims processing and Facets experience required
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

Licensure and Certification:

Six Sigma or other performance improvement experience is preferred

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$66,700.00 - $106,700.00

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.