Business Analyst III - HEDIS
Company: Centene Corporation
Location: Jefferson City
Posted on: January 22, 2023
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Job Description:
You could be the one who changes everything for our 26 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Position Purpose: Perform various analysis and interpretation to
link business needs and objectives for assigned function.
--- Support business initiatives through data analysis,
identification of implementation barriers and user acceptance
testing of various systems
--- Identify and analyze user requirements, procedures, and
problems to improve existing processes
--- Perform detailed analysis on multiple projects, recommend
potential business solutions and ensure successful
implementations
--- Identify ways to enhance performance management and operational
reports related to new business implementation processes
--- Coordinate with various business units and departments in the
development and delivery of training programs
--- Develop, share, and incorporate organizational best practices
into business applications
--- Diagnose problems and identify opportunities for process
redesign and improvement
--- Formulate and update departmental policies and procedures
--- Serve as the subject matter expert on the assigned function
product to ensure operational performance.
--- Ability to travel
Education/Experience:
Bachelor's degree in related field or equivalent experience. 4-6
years of business process or data analysis experience, preferably
in healthcare. Advanced knowledge of Microsoft Applications,
including Excel and Access preferred. Project management experience
preferred.
Benefits and Payment Configuration:
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis, preferably in healthcare (i.e.
documenting business process, gathering requirements) or claims
payment/analysis experience. Advanced knowledge of Microsoft
Applications, including Excel and Access preferred. Experience in
benefits, pricing, contracting or claims and knowledge of provider
reimbursement methodologies. Knowledge of managed care information
or claims payment systems preferred. Previous structured testing
experience preferred.
Compliance Coding/Prepay Compliance (Payment Integrity)
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis (i.e. i.e. documenting business
process, gathering requirements). Experience in healthcare
industry, preferably with managed care techniques and
administrative philosophy. Experience in claims coding analysis or
medical claim review/research preferred. Knowledge of Amisys claims
payment system and Business Objects preferred.
Encounters:
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis (i.e. documenting business
process, gathering requirements) experience in healthcare industry
or 3+ years of managed care encounters experience. Advanced
knowledge of Microsoft Applications, including Excel and Access
preferred. Experience with encounters or claims business analysis
experience in healthcare, preferably managed care or Medicaid.
Knowledge of Amisys or other claims system, HIPAA transactions
(i.e. 837, 999, 824, 277) and SQL Scripting preferred.
Medicare
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis (i.e. documenting business
process, gathering requirements). Experience in healthcare
industry, preferably with managed care techniques and
administrative philosophy. Experience in managed health care
experience, preferably with Medicare. Experience working with and
leading diverse teams in matrix managed environments. Advanced
knowledge of Microsoft applications, including Excel and Access
preferred. Project management experience preferred.
Provider Data:
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis (documenting business process,
gathering requirements) experience in healthcare industry and/or
working in a data driven environment. Advanced knowledge of
Microsoft Applications, including Excel, Project, and Visio
preferred. Knowledge of data migration, software
enhancement/planning, and Agile preferred. Experience managing
projects with a high reliance on technology.
Member & Provider Solutions
Bachelor's degree in related field or equivalent experience. 4+
years of business process analysis (i.e. documenting business
process, gathering requirements) experience in healthcare industry
and/or customer service or enrollment functions. Advanced knowledge
of Microsoft Applications, including Excel and Visio preferred.
Experience managing projects with a high reliance on technology.
Knowledge of data integration, software enhancements/planning and
Agile preferred.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
**TITLE:** Business Analyst III - HEDIS
**LOCATION:** Various, Missouri
**REQNUMBER:** 1349660
Keywords: Centene Corporation, Jefferson City , Business Analyst III - HEDIS, Professions , Jefferson City, Missouri
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