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Senior Business Analyst, Government Programs Operations Claims & Encounters

3 months, 2 weeks ago
United States
Full-time
Mid Level
Business Analyst
Data Science and Analytics
Agile SQL
Apply Now
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
View All Jobs 30

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

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