Job Summary:
The Operations Business Analyst III is responsible for reviewing and analyzing the effectiveness and efficiency of existing Enrollment processes and systems, and participate in development of solutions to improve or further leverage these functions.
Technical Proficiency in HIPAA 834, DTRR, RCNI, RCNO, and MMR processes
SQL proficiency and Enrollment Data Analysis is preferred.
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
- Takes a leading role in the 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
- Takes a leading role 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
- Mentor Business Operations Analyst/Associates to achieve cross-functional capability with project execution and subject matter expertise
- Perform any other job duties as requested
Education and Experience:
- Bachelor of Science/Arts degree or equivalent work experience is required
- Five to eight (5-8) years of health care operations experience in insurance, managed care, or related industry is required
Competencies, Knowledge and Skills:
- Knowledge of regulatory reporting and compliance requirements
- 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:
$81,400.00 - $130,200.00
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):
Salary
Organization Level Competencies
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Create an Inclusive Environment
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Cultivate Partnerships
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Develop Self and Others
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Drive Execution
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Influence Others
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Pursue Personal Excellence
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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.
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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