Service Integration Analyst II - Grievance and Appeals Experience Required

Job Summary:

The Service Integration Analyst II collaborates with the Business Integration team to integrate new products and lines of business into the grievance and appeals department.

Essential Functions:

• Support the management and execution of new market implementations, expansion and plan renewal needs and initiatives for Grievance and Appeals
• Maintain detailed project plans, reports, business decision documentation, meeting minutes and notifications on assigned work and maintain related documentation for each market/product
• Provide weekly reports to G&A leadership on implementation progress
• Work with the G&A Product Owner and G&A Leadership to support the development and execution of new and existing market implementation needs and ensure the completion of necessary signoffs for on time deliveries
• In collaboration with PO and G&A leadership, ensure testing plans and scenarios for implementations are incorporated into appropriate project plans
• Drive the resolution processes for the rapid resolution of issues advanced through new and existing market implementations, expansions and plan renewals
• Support root cause determination process and related remediation plans through the deployment of analytical and reporting resources
• Ensure implementation milestone deliverables are approved and completed to ensure successful implementation of initiatives
• Perform any other job duties are requested

Education and Experience:

• High School Diploma is required
• Bachelor of Science degree in Management Information Systems, Business Analysis, or equivalent work experience is preferred
• Minimum of two (2) years of customer service experience related to healthcare payer dealing with both members and providers is required
• Experience translating business requirements into technical specifications is required

Competencies, Knowledge and Skills:

• Experience with SAS and SharePoint is preferred
• Proficiency in Microsoft Office is required
• Ability to understand and translate accreditation and regulatory requirements into business requirements
• Ability to document and maintain system requirements including process flows is required
• Ability to analyze processes and produce recommendations for improvements is required
• Ability to develop, prioritize and accomplish goals
• Ability to keep current on technologies through self-directed learning
• Excellent written and verbal communication skills
• Strong interpersonal, active listening and critical thinking skills

Licensure and Certification:

• Lean Six Sigma, Project Management highly desired

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Ability to travel as required by the needs of the business

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/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. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.