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Business Analyst - Senior Products

Company: TalentBoost (Point32Health)
Location: Arlington
Posted on: November 19, 2022

Job Description:

-Under the supervision of a Membership Operations Manager, this individual will serve as a Business Analyst II for the Membership Operations Department. The Business Analyst will actively participate in project initiatives sharing subject matter expertise to achieve business goals; ensure compliance with all CMS & State regulations and internal department processes while fully supporting the expansion of production offerings and process changes as a result of such. The Business Analyst II will also support the monitoring of quality controls and team members' progress to advise Manager of areas of opportunity or improvement.KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS* (in order of importance)Provide project support as an project participant or area project lead for large-scale organizational projects by providing the operational perspective and/or leading an operations/functional area subgroup. Provide data and analytic support of these projects post go live to ensure proper monitoring of implementation.Project Type Examples:

  • Corporate Agenda Projects
  • Interdepartmental Cross Functional Initiatives
  • New product developmen
  • May generate reports for Mem Ops teams as well as departments as needed and directed by the Manager.
  • May provide detailed analysis that supports all aspects of member and servicing. This includes measuring and monitoring KPI's.
  • Analyze and document business requirements and specifications to support enhancements to existing reports and the generation of new reports.
  • Monitor and update requirements as needed, implementing change control procedures as required.
  • Participate in business/systems planning as needed.
  • Collaborate with the business to understand the major drivers both internally and in the market that will influence our results. Apply this knowledge in reviewing and interpreting data.
  • Provide analysis for consulting initiatives including development of recommendations and opportunities for improvement.
  • Support Membership audits mandated by CMS as well as state audits by pulling universes, creating specification documents, and attending audit sessions representing the Membership Operations department.
  • May maintain the Medicare Secondary Database
  • May provide assistance regarding Reconciliation Processes and Coordination of Benefits Processes
  • May provide support for the clinical Hedis requirements as needed
  • May train others in Membership Operations processes and procedures
  • May assist in managing the development of training materials and plans; seek assistance appropriately
  • Provide coaching to staff within a specific functional area and support coaching in other areas within Membership Operations
  • Support Manager/Supervisor/ and or Team Leads across all Mem Ops teams
  • Support Business Analysts across Mem Ops department
  • All other duties as directed by Managers across Membership OperationsRequirementsEDUCATION: (Minimum education required)
    • Associates degree or Bachelors' degree preferred (i.e. Business Administration/Management, Healthcare concentration, etc.)EXPERIENCE: (Years of experience)
      • 3-5 years of experience in a related business environment. SKILL REQUIREMENTS: (Include interpersonal skills)
        • Effective communication skills (verbal, written).
        • Ability to independently handle escalated issues
        • Ability to perform thorough research and analysis, documenting results, and communicating to various audiences
        • Quick learner
        • Demonstrated attention to detail, achieving a high degree of accuracy
        • Strong time management skills in order to effectively multi-task while meeting established deadlines
        • Proficient in usage of Microsoft Office Excel, Microsoft Access knowledge a plus
        • Ability to become proficient in navigating through internal & external system applications
        • Demonstrate flexibility, commitment, and resiliency in times of business and organizational change
        • Demonstrate professional demeanor at all times
        • Support collaboration across Membership Operations and other departments and work cooperatively as a team member
        • Provide/accept constructive criticism for improvement, including peer and Manager feedback for performance. Coach others to do so as well.WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)
          • Fast-paced office environment handling multiple demands
          • Requires that the individual be organized while being readily adaptable to changes in work priorities
          • Must be able to work independently and in a team environment CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.Commitment to Diversity, Equity & InclusionPoint32Health is committed to making diversity, equity, and inclusion part of everything we do from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.COVID PolicyPlease note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.About the CompanyPoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.We enjoy the important work we do every day in service to our members, partners, colleagues and communities.This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.Req ID: R5451

Keywords: TalentBoost (Point32Health), Arlington , Business Analyst - Senior Products, Professions , Arlington, Massachusetts

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