Operational Business Analyst (Finance Exp Required)

Purpose of the job

On behalf of internal and external customers, the Operational Business Analyst will proactively identify operational inefficiencies and implement goal-oriented strategies to enhance current processes. This role will manage operational data such as member and provider call data, claims, and enrollment information to recommend business solutions based on research and analysis. This role will also act as a point of reference for complex financial inquiries, budgeting strategy, and financial research and analysis.

Qualifications

REQUIRED QUALIFICATIONS

Required Work Experience

• 5 years of experience in healthcare or insurance field with emphasis on Business Analysis
• 5 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business
• 5 years of experience triaging complex issues from member and/or providers.
• 3 years 5years of experience in finance, financial systems, or systems interfacing with finance field

Required Education

• High-School Diploma or GED in general field of study (All Levels)

Required Licenses

• N/A

Required Certifications

• N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience (All levels)

• 8 years of experience in healthcare or insurance field with an emphasis on Business Analysis.
• 8 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside the business
• 8years of experience in finance, financial systems, or systems interfacing with finance field
• 8 years of experience in project management

Preferred Education

• Bachelors Degree in Computer Science, Information Systems, Business, or related field (All levels)

Preferred Licenses

• N/A

Preferred Certifications

• Business Analyst Certification (All levels)
  

ESSENTIAL job functions AND RESPONSIBILITIES

• Write and review business requirements, flow specifications or change requests
• Conduct research and analysis for issue resolution relating to electronic transactions, customer service applications, claim adjudication systems including reporting, process efficiencies. Track all items through to resolution.
• Provide first or second level support for internal/external customers
• Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
• Act as a liaison between external/internal customers and proactively collaborate and communicate with Service Operations leaders
• Provide subject matter expert (SME) advice related to identifying, researching, and analyzing operational challenges, while identifying solutions to implement.
• Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities.
• Lead small to medium size projects;
• Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency and completeness
• Resolve differences between customers and other team members in order to achieve organizational and project goals
• Utilize existing reporting tools to develop and execute data queries for ad hoc requests; understand data source structures
• Develop complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with little to no management direction.
• Decompose high-level project information and evaluates project components to forecast work effort required
• Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business.
• Fully support all business segments
• Act as lead business analyst for large or complex projects with minimal guidance from lead or manager
• Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals
• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Participate in on-call rotation
• Perform all other duties as assigned