Appeal and Grievance Business Analyst

extra parental leave
Work set-up: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)
Work from: 

Offer summary

Qualifications:

Bachelor's degree required., Minimum of 5 years of experience in a quantitative role such as Business Analyst or Data Analyst., Experience with healthcare industry and managed care., Proficiency in QNXT, system analysis, and data analysis techniques..

Key responsibilities:

  • Facilitate business process improvements through analysis and documentation.
  • Coordinate requirements development and testing activities.
  • Collaborate with IT on department-related efforts and system enhancements.
  • Support data analysis, reporting, and stakeholder communication.

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Job description


Job Summary:
  • The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review and documentation of functional business specifications.
  • This position manages the requirements development process through the elicitation, analysis, specification and verification of multiple levels of requirements from an endtoend perspective and supports the ongoing management of the requirements.
  • This position will develop report and analysis for the department.
  • It is responsible in communicating and coordinating with IT on a daytoday department related effort.
  • The Business Analyst III will manage and coordinate the implementation andor integration of products or new features for clients including client training and provides subject matter expertise (SME) and support of the departments inbound and outbound functions.
  • This position will act as mentor to Business Analysts I II.
    • Key Requirements of this position:
      • QNXT Experience.
      • Healthcare industry.
      • Proven analyticaltechnical aptitude evidenced by at least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, Encounter Processing.
      • Bachelor Degree.
      • Managed Care experience
        • Duties:
          • Develop functional and user acceptance test plans and scenarios.
          • Coordinate functional and user acceptance testing by executing the testing strategy, scheduling resources and tracking test performance.
          • Perform data analysis to support evaluation of system defects or to develop requirements for new functionality; assist in various system trouble shooting and balancing and correction efforts including analysis, verification and validation of issues and fixes.
          • Coordinate activities including ontime delivery, testing and production moves.
          • Collaborate with I.T. on all department related efforts, including submission of Service Requests and writing BRDs.
          • Coordinate related data requests from internal departments, andor assist I.T. with definition of criteria.
          • Delegate data and reporting requests to business analysts.
          • Facilitate collaborative system and data design sessions with the user community, technical architecture resources and development resources.
          • Preparation of status updates to enterprise for distribution and communication.
          • Work as a technical support and liaison to designated I.T. personnel to provide testing, support and feedback on enhancement requests and regular updatesreleases; adhere to release schedules.
          • Provide analytical support for critical corporate initiatives including business function support for system migrations and consolidations, significant business area process improvement projects and complex product installations.
          • Demonstrate a high level of subject matter expertise in functional area to bridge business requirements and I.T. solutions; provide technical direction and ensure compliance with best practice solutions. Practice knowledge transfer and foster change management as the organization changes and new skills are required, focusing on teamindividual development to be a valued contributor.
          • Participate and contribute on the development creation of data models and interface design specifications.
          • Support internal external stakeholders roadmap and audits as needed
          • Oversee the business process support across multiple client engagements.
          • Communication with internal external stakeholders for departments submission requirements.
          • Review submission of data against established benchmarks and coordinate correction and improvement efforts.
          • Monitor timely and accurate outbound data submission to state and federal recipients.
            • Required Skills:
              • Competent to work at the highest technical level of most phases of systems analysis.
              • Excellent verbal and written communication skills.
              • Coaching, Mentoring and Teaching skills.
              • Teamworkfocusedcollaborative work style.
              • Demonstrated ability to work successfully on large projects.
              • Problem solving skills evidenced by demonstrated results in past positions.
              • Ability to work under tight deadlines and handle multipledetailoriented tasks.
              • Ability to influence at all levels of the organization.
              • Proficient in Microsoft Office and MS Visio.

Required profile

Experience

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

Other Skills

  • Communication
  • Time Management
  • Teamwork
  • Mentorship
  • Microsoft Office
  • Coaching
  • Problem Solving

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