Care Coordination Business Analyst

Overview

The Care Coordination Business Analyst will design, produce, and analyze Care CoordinationDepartment operational data in support of department objectives and goals. Works closely withbusiness users and Configuration to write business requirements, test plans, implementation plans,and other project documentation. Utilize knowledge of numerous applications, databases,information systems, statistical tools and analytical principles to monitor and analyze informationrelated to department operations. May assist Care Coordination Senior Program Manager onmore complex projects.

Responsibilities

▪ Serves as a liaison for Care Coordination to Configuration, IT, Analytics teams andexternal stakeholders to define business requirements and identify data needs.▪ Maintains in-depth knowledge of PHC systems from a technical and end-userperspective.▪ Performs analysis, design, configuration, and testing of assigned systems.▪ Uses various resources to troubleshoot and resolve system issues.▪ Collects business requirements and creates flow charts to illustrate the process flow.▪ Under the direction of the Care Coordination Senior Program Manager, works on complexbusiness problems, analyzing and documenting current business processes and systems todetermine process or system needs that will improve performance and/or increaseefficiency.▪ Tests and takes part in implementation of new releases and upgrades.▪ Analyzes new systems and functionality and makes recommendations to businessusers, configuration, and IT.▪ Communicates system changes and processes to appropriate personnel, documentingany processes as necessary.▪ Writes processes and procedures.▪ Coordinates with Care Coordination Program Managers and Department leaders to prepareand validates DHCS and/or NCQA reports for Health Services.▪ Participates or leads the creation of report requirements to be ran to identify departmenttrends and compliance.▪ Runs ad hoc reports and dashboards as requested and use to support business requirementrecommendations.▪ Monitors health plan policies and procedures and assist with documenting CareCoordination related business requirements and decisions that result fromconfiguration, system implementation, and other change driven sources.▪ Participates in system upgrade/update testing as needed▪ Develops short and/or long-term resolutions by identifying root causes using reportingand other data files available.▪ Maintains regular and consistent contact with operations management, clinicalleadership, and appropriate health plan leaders.▪ Performs other tasks as assigned to ensure integrity of data and accurate reporting.▪ Participates in special projects as needed.▪ Other duties as assigned.

Qualifications

 

Education and Experience

Associates degree in related field preferred; Minimum of two yearshealthcare experience, preferably in managed care environment; orequivalent experience and training that would provide the knowledgeand acquired skills and abilities listed above.

 

Special Skills, Licenses and Certifications

Demonstrated aptitude for acquiring and applying technical skills indata analysis, reporting and data systems. Strong analytical skillsincluding knowledge of statistics. Valid California driver’s license andproof of current automobile insurance compliant with PHC policy arerequired to operate a vehicle and travel for company business.

 

 

Performance Based Competencies

Knowledge of MS Excel and other analytic software. Detail-orientedwith strong organizational skills and project management skills to workon multiple projects simultaneously within establish timeframes.Excellent written and oral communication skills.

 

Work Environment And Physical Demands

Ability to use a PC with standard software packages and a 10 keycalculator. More than 70% of work is spent in front of a video displaymonitor. When required, ability to move, care, and/or lift objects ofvarying sizes weighing up to 25 lbs. Must be able to operate a car forcompany business.

 

 

 

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

 

$77,430.47 - $96,788.08

 

IMPORTANT DISCLAIMER NOTICE

 

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exh