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Business Analyst III (Healthcare)

El Segundo, CA · Information Technology
Position Overview:
Responsible for performing routine and moderately complex activities under limited supervision in order to design, implement, maintain and support policies, processes and systems related to Medicare risk adjustment. Interacts with a wide variety of central support departments, as well as site and regional staff, to accomplish goals.
 
Responsibilities:
  • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
  • Project management of programs by working with vendors and communities to set up and manage projects to completion.
  • Monitors programs to ensure data flows through the system as expected.
  • Maintains weekly program reporting for various audiences, reconciles program invoices, and calculates ROIs.
  • Processes additional data into the system, ensures that data was processed and researches any interruptions to the process.
  • Performs quality assurance on data and file submissions to Health Plans during CMS Sweep periods.
  • Query, analyze, and interpret data for ad hoc analyses.
  • Responds appropriately to and quickly resolves issues related to department applications or programs; manages customer expectations by keeping them informed of progress.
  • Develops report specifications and creates complex reports for management or communities using available reporting tools.
  • Gather information needed for compliance related activities.
  • Participates in quality assurance process for all new department related system/application/process changes.
  • Reconciles internal data to Health Plan data.
  • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Performs additional duties as assigned.
 
Education:
  • Bachelor’s degree from a four-year college and/or equivalent work experience in a related field.
 
Experience: 
Minimum:
  • Over 5 years and up to and including 7 years of experience.
  • 3 to 5 years background in healthcare industry and managed care.
  • 3 to 5 years experience with MS Access, Excel, and SQL.
Preferred:
  • 3-5 years project management experience.
  • 1 or more years CMS-Risk Adjustment experience.
  • Experience with Business Intelligence Tools, such as Reporting Services and Analysis Services.
  • Experience with SharePoint site development and maintenance.
 
Knowledge, Skills, & Abilities: 
  • Proficient in Microsoft applications (Access, Excel, Word, SQL).
  • Strong analytical and problem-solving skills.
  • Detail oriented.
  • Experience in data and ad hoc analysis.
  • Experience with working with large data sets and a variety of sources.
  • Ability to work efficiently and accurately, while managing multiple priorities, in a fast paced environment.
  • Proven ability to track and manage all projects, as well as on-going activities within a project.
  • Good English verbal and writing skills.
  • Ability to work in a team environment with minimal amount of supervision.
  • Ability to transfer knowledge and information to teammates from a wide variety of cultural and educational backgrounds.
  • Ability to cope with fluctuating demands of an uneven workload.
  • Customer service-oriented.
 
Kat Forester
ProEnlist, LLC

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