Business Analyst, Operations FT ID-8628

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Job Summary

The Business Analyst, Operations will provide analytical support and strategic planning for UMC Health Plan Operations

Reports to: Director, Health Plan Operations

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Job Specific Responsibilities

  • Perform budgeting, predictive modeling, forecasting, financial reporting, and analysis to support business decisions
  • Communicates with project partners, vendors, providers, and others to ensure adherence to company policies, procedures, and compliance of health informatic records
  • Closely monitor and track plan expenditures and performance metrics to provide detailed reports
  • Make recommendations based on analysis of plan performance, claims experience, and overall vision and direction of UMC Health Plan
  • Prepare, analyze, and interpret statistical data on health plan performance and utilization data
  • Prepares and monitors accounts payable activities, trend data, and plan design shifts
  • Provides cost justification and/ or return on investment (ROI) for potential plan improvements
  • All other assigned duties related to analytics within the assigned department

Education and Experience

  • High School Diploma or GED, Preference for Bachelors degree
  • +2 years analyst experience with health plans or in a healthcare provider environment
  • +2 years working knowledge of Hospital Accounting and/or Provider Network financial management

Knowledge, Skills and Abilities

  • Knowledge of Managed Care principles and health plan industry standards regarding funding and reimbursement methodologies
  • Practice of Cost Accounting standards and principles and practice management analysis
  • Proficient in mining data and manipulating spreadsheets to perform detailed analytics
  • Excellent communication skills, both written and verbal
  • Knowledge of medical terminology and diagnosis coding is helpful

Business Analyst, Operations FT ID-8628

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