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Sr. Business Analyst - ACA & Medicare Programs - Remote

79% Flex
EXTRA HOLIDAYS - EXTRA PARENTAL LEAVE
Remote: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)
Work from: 

Offer summary

Qualifications:

Bachelor's degree in related field, 5+ years healthcare technology industry experience, 5+ years working with ACA and Medicare programs, 5+ years SQL experience, Proven problem-solving skills.

Key responsabilities:

  • Develop process documentation and quality testing plans
  • Champion process improvement initiatives
  • Maintain production management communication
  • Execute operations processes and quality testing
  • Support implementation of new customers and products
Allscripts logo
Allscripts Computer Software / SaaS Large https://www.allscripts.com/
5001 - 10000 Employees
See more Allscripts offers

Job description

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Your missions

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Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.

Veradigm Payer 

Veradigm understands that managed care organizations, pharmacy benefit managers (PBMs), insurance companies, health plans, and other payers need to balance controlling costs with the goal of providing the highest quality of care and optimizing health outcomes for their members.

Solutions from Veradigm Payers:

  • Deliver insights to drive quality outcomes cost-effectively
  • Improve efficiency for themselves, their providers, and their members through high-speed clinical data exchange
  • Impact point-of-care decision making positively by integrating payer guidance and prior authorization management directly in each healthcare provider’s existing workflow

Job Summary

Join the Payer Team as a Senior Business Analyst and support ETL implementations for claims and memberships across new and existing clients. The Senior Business Analyst will be responsible for gathering requirements, defining specs, gap analysis, data mapping, writing SQL queries and client support. This role requires a strong understanding of ACA, Medicare programs and healthcare technology.

This is a remote role.

What you will contribute:

Process Documentation Development and Maintenance:

  • Develop and maintain process flow diagrams, operation policies & procedures, and operations QA testing plans
  • Develop operations checklists and work aids that support the execution of the operations activities
  • Champion process improvement initiatives in the areas of effectiveness (quality) and efficiency (cost)
  • Act as a business owner of the technology and tools that support the assigned operations processes
  • Work closely with operations reporting team to ensure appropriate measurement of the operations processes assigned
  • Support the implementation of new customers and products

Quality Program Documentation and Testing

  • Develop and maintain quality testing plans for each operations process area assigned
  • Develop testing checklists and work aids that support the execution of the quality tests
  • Update testing plans to reflect changes to business requirements and incorporate process improvement initiatives
  • Support the implementation of new customers and products

Production Monitoring/Execution:

  • Maintain the production management communication cadence (production planning, issue reviews, and production outcomes reporting) within operations, the product organization and full company
  • Execute operations processes steps and quality testing for the operations areas assigned
  • Monitor process reporting and quality reporting to identify issues and work to resolve following the issue escalation policies & procedures
  • Maintain a complete and accurate production issues list

The ideal candidate will have:

Academic and professional qualifications:

  • Bachelor's degree in related field of study

Experience:

  • 5+ years healthcare technology industry experience
  • 5+ years' experience working with ACA and Medicare programs
  • 5+ years SQL experience required
  • Proven problem-solving skills in the areas of process management and technology
  • Quality testing experience
  • Strong attention to detail and time management skills
  • Excellent client facing skills

Travel Requirements: 

Less than 10% travel   

Working Arrangements: 

Work can be performed in a standard office environment or in a home office setting. 

Compliance 
 
Job responsibilities include fostering the Company’s compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyone’s responsibility.

#LI-REMOTE

 

 

 

Enhancing Lives and Building Careers

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?

Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.

We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

This is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.

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Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Computer Software / SaaS
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Soft Skills

  • Attention to Detail
  • Client-Facing Experience
  • Time Management

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