Business Analyst

General Information

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Work Location: Los Angeles, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST Posted Date 05/06/2025 Salary Range: $76200 - 158800 Annually Employment Type 2 - Staff: Career Duration indefinite Job # 24119

Primary Duties and Responsibilities

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The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT teams, and external partners. This role is responsible for gathering and documenting business and system requirements, analyzing and interpreting data to support cross-functional operations, and driving system enhancements to improve efficiency and compliance. The analyst will also support testing, report generation, and documentation efforts related to software and process improvements.
Key Responsibilities:

• Gather and define business and technical requirements to support electronic data exchanges and system enhancements
• Collaborate across teams to design and implement effective business solutions
• Develop documentation including business cases, test cases, and process flows
• Perform data analysis and reporting to support operational decisions
• Lead and support audits, quality control initiatives, and performance improvement efforts
• Coordinate with IT and trading partners to implement Tapestry ISS and other system enhancements
• Ensure compliance with organizational policies and regulatory standards

Salary Range: $76,200 - $158,800/Annually

Job Qualifications

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• Bachelor’s Degree in Business Administration, Information Systems, Health Care or other related field required
• Minimum of five years’ experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required
• Minimum of five years’ experience with CMS processes in a Medicare or Managed Care environment required
• Experience with CMS processes is a plus
• Knowledge of SQL window-based computer environment including MS Office and related programs is a plus
• Knowledge of encounter regulatory reporting and compliance requirements.
• Experience managing vendors to contractual requirements.
• Strong ability to research and resolve encounter issues.
• Strong knowledge of the health care model, capitation and other managed care IPA and provider reimbursement methodologies.
• Strong knowledge of physician and facility billing practices, appropriate CPT coding initiatives, ICD-10 coding