Business Analyst III - HEDIS

Company: Centene Corporation
Location: Jefferson City
Posted on: January 22, 2023

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