Managed Care Business Analyst Healthcare Solutions Expert (Remote)

Are you passionate about improving healthcare outcomes and using your skills to make a difference? This role is focused on enhancing the health and well-being of vulnerable community members through innovative technology. You will thrive on problem-solving and be eager to find creative solutions to some of healthcare’s biggest challenges.

Your Role in Our Mission

In this position, you’ll play an instrumental role in helping clients improve health and human services outcomes. You will be key in analyzing, planning, and improving business processes to ensure that technological solutions align with client needs.

Key Responsibilities

• Analyze, design, and document business processes to support clients’ technological goals
• Develop and execute test scenarios to verify that client requirements are met
• Participate in technical reviews and inspections to guarantee project success
• Communicate effectively, both verbally and in writing
• Interpret complex regulatory and procedural documents with ease
• Manage your time effectively while working independently
• Utilize strong analytical skills to solve problems and collaborate with other departments
• Apply knowledge of Medicaid, Member services, Premium Billing, and Managed Care processes
• Multi-task efficiently in a fast-paced environment
• Occasionally work beyond the standard 40-hour week as needed

You will also provide critical support to staff, management, and customers in a healthcare environment, assisting providers, members, and enrollment specialists daily.

Additional Responsibilities

• Coordinate managed care contract activities and assist with policy design, testing, and program implementation related to Member services, Premium Billing, and Managed Care subsystems
• Complete daily tasks related to member services and managed care, coordinating quality assurance activities
• Take a lead role in supporting Managed Care and Premium Billing processes
• Collaborate with various functional areas such as Customer Service, Claims Processing, and Policy

Who We’re Looking For

• 3+ years of experience as a Business Analyst, translating technical requirements into actionable solutions
• A bachelor’s degree or equivalent combination of education and experience
• Familiarity with Medicaid systems and processes, especially in Managed Care and Premium Billing
• Excellent problem-solving skills and a strong analytical mindset
• Strong communication skills, with the ability to present information clearly to both technical and business stakeholders
• A team-oriented approach with the ability to collaborate effectively

What To Expect

• Fully remote options available from most locations within the US and its territories
• Video interviews required during the hiring process, and video participation during the first week of orientation.

Employment Type: Full-Time