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Business Analyst - Operations (Medicaid and SQL experience)

Company: AmeriHealth
Location: Southfield
Posted on: November 10, 2018

Job Description:

Job Brieftechnical and subject matter expert for initiatives involving member enrollment, encounter data processing, and healthcare claimsYour career starts now. We're looking for the next generation of health care leaders.At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at as technical and subject matter expert for initiatives involving member enrollment, encounter data processing, and healthcare claims based reporting. Responsibilities include but are not limited to gaining expertise of the rules & processes around inbound 834 file processing, maintenance of the enrollment data in the core application (Facets), and creation of outputs related to changes made in enrollment processes. The Business Systems Analyst will be a key contact for Medicaid Encounter and Response file reconciliation and support.Support Operation business units by working to define, understand and document report requirements and translating business needs into defined report requirementsUnderstand, propose, and create reports that seek to provide information needed by business unitsLeverage in-depth knowledge of managed care principals, statistical analysis concepts, and health care datasets to support critical business needsDevelop Summary, Detail, Dashboard reports; and management summaries which present data findings in a professional, concise and readable format appropriate for content and audienceGather supplementary data from various sources; exploring data using quantitative, and visualization toolsCreate thorough and consistent documentation for the systems, tools, and programs used to create routine reports and the detailed databases/data attributes used in routine reportingConduct and continuously improve reporting to ensure reliability, validity, and integrity of the data used in management reporting and analysis--Education/Experience:Required--Bachelor's Degree or equivalent experience.Required 3-5 years of proven--professional business analysis or system analysis experience in an operations environment.Required and proven Medicaid experience is a must.Required experience defining problems, collecting data, establishing facts, and recommending solutions.Required demonstrated ability to clearly communicate (written and oral) problems and solutions to all levels of an organization.Required skilled interpersonal communication and customer service.Required ability to work--with and through others to achieve results.Required----prior experience with SAS or SQL, Facets and Case Management tools (preferred)Preferred healthcare experience strongly.BackShareApply Now

Keywords: AmeriHealth, Southfield , Business Analyst - Operations (Medicaid and SQL experience), Professions , Southfield, Michigan

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