Senior Business Analyst, Government Programs Operations Claims & Encounters

4 months, 1 week ago
Full-time
Mid Level
Data Science and Analytics
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017

Description

  • Gather, document, and maintain business and reporting requirements aligned with state and federal guidelines.
  • Analyze complex business and data issues using information from internal and external sources.
  • Create specification documents for business processes, reports, data extracts, and analyses based on business needs.
  • Identify trends, outliers, and patterns in datasets to support process improvements.
  • Collaborate with cross-functional teams to design, refine, automate, and maintain operational capabilities.
  • Monitor changes in business processes and update documentation accordingly.
  • Intake, analyze, and manage stakeholder requests.
  • Drive root-cause analysis and resolution of data and process issues by partnering with key stakeholders.
  • Support government data submission processes and improve submission workflows to meet regulatory requirements.
  • Prepare end-user documentation, training materials, and performance metrics for stakeholder distribution.

Requirements

  • 3+ years of healthcare experience.
  • 3+ years of business process analysis experience, preferably in healthcare.
  • 3+ years of experience with Government Exchange programs.
  • Demonstrable knowledge of SQL, Excel, and flow-charting tools.
  • Experience with implementation and/or project management.
  • Experience working with cross-functional teams.
  • Bachelor’s degree in Business Administration, Data Analytics, or Computer Science, or 3+ years of relevant experience.
  • Familiarity with the agile framework preferred.
  • Certified Scrum Product Owner preferred.
  • Strong organizational skills, flexibility, and excellent communication skills.
  • Attention to detail and commitment to delivering high-quality work product.
  • Comfort working in a fast-paced, growing environment.

Benefits

  • Hybrid work option local to NYC or Denver, or remote within the U.S.
  • Salary range of $90,000 to $105,000 USD.
  • Equal employment opportunity and a diverse, inclusive workplace.
  • Retention of personal data for consideration for future roles.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

AI Systems Integration Specialist

Hireframe 51-250 Professional Services

Hireframe is seeking an AI Automation and Systems Integration specialist to design, optimize, and maintain AI-powered workflows that connect business platforms and streamline operations.

Notion
18 hours, 42 minutes ago

GTM Strategy & Analytics Manager

ChowNow 251-1K Hotels, Restaurants & Leisure

ChowNow is seeking a remote GTM Strategy and Analytics Manager in the U.S. to serve as the performance and strategic analytics lead for its sales and post-sales organization, improving planning, execution, and resource allocation.

HubSpot Salesforce SQL
1 day, 18 hours ago

DoW SkillBridge Targeting Operations Internship

Research Innovations 251-1K Aerospace & Defense

Research Innovations, Inc. is seeking a transitioning service member for a remote DoD SkillBridge internship supporting its CJADC2 team and Joint Targeting Platform through operational analysis, systems engineering, user engagement, and targeting expertise.

1 day, 18 hours ago

Senior SAP S/4HANA Business Analyst (FI/CO)

Qualysoft 251-1K Internet Software & Services

Qualysoft Group is seeking an SAP professional to analyze and document activities, role allocations, competencies, and capacity requirements across Finance, Controlling, and Accounting landscapes ahead of an SAP S/4HANA transition.

1 day, 18 hours ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers