Business Analyst - USFHP at Providence

Seattle, Washington, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Dec, 25

Salary

0.0

Posted On

20 Sep, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Business Analysis, Managed Care Operations, Microsoft SQL Server, CPT Coding, ICD-9 Coding, ICD-10 Coding, Financial Functions, Clinical Functions, Data Reporting, Utilization Management, Quality Management, Healthcare Software, HEDIS Reporting, Access Database, Vendor Management, Fee Schedule Management

Industry

Hospitals and Health Care

Description

Responsible for maintaining and updating the GE/Centricity/IDX Managed Care Application (MCA) module for US Family Health Plan's managed care line of business: builds fee schedules, provider and vendor dictionary entries, and plan benefits and exclusions. Assists with health plan utilization management reporting for the organization. Responsible for ensuring that optimal payment methodology is in place for payments from US Family Health Plan to vendors and other providers. Responsible for all reports and data transfers to the Department of Defense and its contractors. Provides support for the quality management program. Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required qualifications: Bachelor’s Degree in related field or Equivalent experience in Health Care Business Administration as required by URAC. Minimum of four years’ experience in managed care operations or large group practice setting. Microsoft SQL Server experience Must have knowledge of and experience in coding with both CPT and ICD-9 and ICD-10. Must possess an understanding of financial/administration/clinical business functions and the interfaces/relationships between applications in healthcare. Preferred qualifications: Experience with Access and reporting from a warehouse type database. Experience with HEDIS reporting desired. Experience with GE/Centricity/IDX healthcare software application desired. Clinic setting operations experience highly desirable as complementary experience to the above. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.

Responsibilities

The Business Analyst is responsible for maintaining and updating the Managed Care Application module for the US Family Health Plan. This includes building fee schedules, managing provider entries, and assisting with utilization management reporting.