UM Business Analyst

at  Centers Plan for Healthy Living

Centers Plan for Healthy Living’s goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.

JOB SUMMARY:

This position is responsible for ensuring operational effectiveness through critical analysis and reconciliation of data gathered from multiple sources, and creating timely reports in all aspects of the Utilization Department. This position requires someone with strong analytic skills, ability to gather business requirements, craft data into usable reports, track and trend issues, and provide feedback on solutions.

EDUCATION AND EXPERIENCE:

Education
Required: College degree in related area (computer science, health sciences, business administration)
Specific Technical Skills
Required: Proficiency with MS applications, including but not limited to Word, Excel, Outlook, Power Point, and Access

KNOWLEDGE AND SKILLS:

• Excellent interpersonal and communication skills.
• Ability to communicate effectively with all levels of management.
• Ability to handle multiple projects simultaneously
• Effective analytical skills
• Knowledge of financial and medical modeling systems.

PHYSICAL REQUIREMENTS:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Able to operate computer equipment
• Able to communicate by phone and in writing

The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification. They should not be construed as an exhaustive list of all responsibilities, duties and skills required.
Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment

PRIMARY RESPONSIBILITIES:

• Analyze incoming requests, identify issues, determine root causes, and participate in the development of solutions
• Work with various applications and information in member records
• Report reconciliation, development, and presentation on a timely basis
• Participate in standing meetings as necessary, involving, but not limited to data warehousing, medical management, claims, and provider relations
• Liaison with various vendors to solve applicable issues or answer inquiries
• Collaborate with other Business or System Analysts and Project Managers in the execution of various projects
• Perform other duties and special projects as assigned
• Assist in the preparation and submission of all regulatory reporting as required by state and federal guidelines
• Participate in departmental audits and process enhancements/improvements

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Able to operate computer equipment
• Able to communicate by phone and in writin