Managed Care Business Analyst Healthcare Solutions Expert (Remote)

Are you ready to use your skills to make a difference in healthcare? This role involves leveraging innovative technology to improve the well-being of those most in need. You will join a team of dedicated professionals committed to tackling some of healthcare’s biggest challenges with cutting-edge solutions. Your contribution will be vital in helping clients achieve better health and human services outcomes.

Your Impact

In This Role, You Will Have The Opportunity To

• Use your expertise to support clients in delivering better healthcare services through advanced technology.
• Analyze and refine business processes to drive improvements across the healthcare landscape.
• Analyze, plan, and design solutions to optimize business processes in alignment with client goals.
• Create and assess test scenarios to ensure client requirements are integrated into the system design.
• Participate in reviews and inspections throughout all phases of projects to ensure successful implementation of changes.
• Communicate complex regulatory and procedural information clearly.
• Work independently, managing your time and priorities effectively and with minimal supervision.
• Collaborate with multiple departments and stakeholders using strong analytical skills.
• Apply your understanding of Medicaid, Member, Premium Billing, and Managed Care processes, policies, and system logic.
• Maintain flexibility and adaptability in a fast-paced, multi-tasking environment.
• Occasionally work beyond a standard 40-hour workweek when required.

In this position, you will serve as an analyst supporting staff, management, and customers in a healthcare setting, acting as a resource for providers, members, and enrollment specialists.

Additional Responsibilities

• Coordinate managed care contract activities and assist in policy design, testing, and program implementation for Member, Premium Billing, and Managed Care subsystems.
• Oversee daily tasks related to members and managed care, ensuring quality assurance (QA) and collaborating with various teams.
• Actively support Managed Care and Premium Billing operations, taking a lead role in key activities and responsibilities.
• Collaborate with other functional areas such as Customer Service, Claims Processing, TPL, Prior Authorization, Policy, and SURS.

This role is a critical part of the Managed Care and Premium Billing Team, which oversees promotion, enrollment, maintenance, and education regarding managed care and premium billing functions.

What We’re Looking For

• Three or more years of experience as a Business Analyst, with a proven ability to turn technical requirements into actionable solutions for clients.
• Bachelor’s degree or equivalent combination of education and experience.
• Experience working with Medicaid systems, specifically Kansas Modular Medicaid System and Kansas Medicaid.
• Strong analytical and problem-solving skills.
• Excellent communication and presentation skills for effective engagement with business leaders, clients, and technical teams.
• Ability to work well within a team and collaborate across various departments.

What You Can Expect

• Fully remote work opportunities available from most locations across the U.S.
• Video interviews will be conducted for all candidates, with cameras required during the first week of onboarding.

Employment Type: Full-Time