Job description

The Ancillary and Pharmacy Programs Department is responsible for ensuring enrolled members receive access to Ancillary benefits such as pharmacy, dental, non-emergent transportation, over-the counter, food and routine hearing and vision, as such enrolled members must be present in all appropriate downstream systems to ensure that members receive all services and benefits associated with their enrollment. The Ancillary and Pharmacy Programs provide analytical and operational support to the end-to-end enrollment process. The department supports continuous improvement, including reports, operational workflows, gap and data analysis, and processes analysis.

The Analyst reports directly to the Senior Director of Ancillary Programs. He/She should be a self-starter and effective collaborator, showing strong interest in operations, data analysis, process improvement, strong technical/analytical and problem-solving skills, as well as good written and oral communication skills.

Required:

Bachelor's Degree in information systems or related quantitative field required (Finance, Business, Computer Science, Mathematics, Economics, or similar)

Required:

• 2 -- 4 years of experience
• 2+ years of analytical experience with data or statistical analysis in healthcare industry
• 2+ years of experience in developing and using large relational database modeling concepts and practices (SQL Reporting, or similar)
• 2+ years SQL Server programming experience
• 2+ years of experience with BI products such as, Tableau, Looker
• Strong math and analytical skills
• Strong excel skills
• Health care industry experience

Required:

• Advanced knowledge of Excel, including use of Pivot tables and SQL
• Strong understanding of financial concepts and/or managed care
• Ability to establish and maintain positive and effective work relationships with internal staff, external vendors, and state and federal agencies
• Proven ability to translate business needs into BI requirements
• Proven skills and judgment necessary for independent decision-making
• Strong organizational, time-management and problem-solving skills
• Ability to work independently and within a team environment
• Strong communication skills both written and verbal
• Critical listening and thinking skills

Required:

English

Responsible for bridging the gap between IT and the business using data analytics to assess processes, determine requirements and deliver data-driven recommendations and reports to stakeholders.

Reports

• Develops reports using tools such as Tableau, Looker, SQL server, and Excel to automate and optimize processes and to track and assess performance
• Creates reports to support and track end-to-end enrollment from internal to external systems.
• Partners with IT, Sales, Ancillary, Clinical, and Claims teams to support end-to-end enrollment.

Process Improvement

• Partners with IT, Sales, Ancillary, Clinical, and Claims teams to develop and review workflows, to streamline processes and increase efficiency
• Facilitates exploratory sessions to develop a shared understanding of a business problem, the possible solutions and next steps. Documents requirements based on the outcome of the sessions and maps it to meet CCA requirements.
• Creates Visio diagrams or other visualizations to use in prototype review sessions

Process Monitoring

• Monitor processes to ensure regulatory compliance, and to identify opportunities for continuous improvement

Data Analysis

• Analyzes large sets of data, summarizes, and presents results
• Develops and analyzes quantitative reports to assess enrollment, vendor optimization and adherence to policies and procedures related to various topics
• Tracks, analyzes, and resolves enrollment issues

Liaison between ERR and Other Departments

• Coordinates and liaises between ERR and other departments, when applicable, such, as CCA's Claims Department, CCA's Third Party Administrators, IT, and Clinical Departments

Job Type: Full-time

Pay: $54,222.64 - $86,000.00 per year

Schedule:

• 8 hour shift

Education:

• Bachelor's (Preferred)

Experience:

• Microsoft Excel: 1 year (Preferred)

Work Location: Remote

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