CCA Clinical Ops

Job Summary:

The Clinical Operations Business Analyst is responsible for the development of reports, analytics, and recommendations to ensure continuous process improvement and gap closure. This role reviews policies and regulatory requirements, analyzes data and creates recommendations to improve operational functionality, and leads projects of variable size, scope, and complexity, directly engaging with senior leaders.

Essential Functions:

• Engages with stakeholders to understand current processes/systems and pain points as well as elicit detailed business needs of/gather requirements for reports and tools
• Develops reports by querying the database using SQL or any related programming language and analyzing data to ensure accuracy
• Promote new and innovative recommendations to improve accuracy reporting such as robotic process automation (RPA).
• Creates visualizations using Tableau, Looker, Excel
• Analyzes large sets of data, summarizes, and presents results
• Develops and analyzes quantitative and qualitative data to meet compliance and operational needs, supporting different departments such as Assessments, Authorizations, Appeals and Grievances, Claims, etc.
• Partners with clinical operations management to develop and review workflows, to streamline processes and increase efficiency.
• Generates insights and develops recommendations for solutions
• Creates Visio diagrams or other visualizations to use in prototype review sessions
• Plays a role in developing and managing major clinical operations analytic projects
• Serves as liaison between Business Intelligence team and various departments within Clinical Operations, translating the business needs into BI requirements for reports, dashboards, and tools
• Performs any other job related duties as requested.

Education and Experience:

• Bachelor's Degree in information systems or related quantitative field required (Finance, Business, Computer Science, Mathematics, Economics, or similar) required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Two (2) years SQL Server programming experience required
• Two (2) years of experience with BI products like, Tableau, Alteryx, Looker required
• Two (2) years of analytical experience with data or statistical analysis in healthcare industry required
• Experience with robotic process automation (RPA) preferred
• Managed care/provider contract modeling experience preferred

Competencies, Knowledge and Skills:

• Advanced knowledge of Excel, including use of Pivot tables, and SQL
• Strong math and analytical skills
• Strong understanding of financial concepts
• 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

Licensure and Certification:

• None required

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required

Compensation Range:

$72,200.00 - $115,500.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-AS1