Business Systems Analyst - Claims (Operations & Policy Analyst 2)
State of OregonAbout the role
Initial Posting Date:
05/23/2024Application Deadline:
06/02/2024Agency:
Oregon Health AuthoritySalary Range:
$4,998 - $7,647Position Type:
EmployeePosition Title:
Business Systems Analyst - Claims (Operations & Policy Analyst 2)Job Description:
Do you have experience applying data systems expertise to operationalize policies and programs that seek to ensure equitable access and high quality health care services and supports? Are you enthusiastic about analyzing data to create solutions and ensuring the efficiency of information systems through research and data testing for Oregon Health Plan members? We look forward to hearing from you!
Click Here to view a Dashboard of all current recruitments for the Behavioral Health Division, Medicaid Division, and the Office of Data Strategy & Operations (which were previously all part of OHA's Health Systems Division). The specific positions associated with this posting are listed under REQ-157569. The dashboard identifies the business area (“Section”) and Unit for each position and also provides a link to a position description to offer you greater context for the role. Section 1 of the position description outlines Position Information, including Work Location and Supervisor Name. Section 3 outlines the Description of Duties. In some circumstances, a position summary will be posted; selected candidates will be provided the full position description at time of hire.
This posting will be used to fill one (1) full-time position. The position is classified and is represented by a union.
Work Location: Salem/Marion; hybrid position
What you will do!
This position serves as a business analyst focused on identification, solution design and resolution of Medicaid claims-related work within the Medicaid Management Information System (MMIS). This position will focus on issues related to claims adjudication within the MMIS, including research of claims and how they are processing within the system. Additionally, this position will be responsible for testing change requests for the MMIS that have a claims subsystem impact.
This position also participates and collaborates with multiple business partners across the Oregon Health Authority (OHA), Oregon Department of Human Services (ODHS) and various shared services programs to find resolution for outstanding claims issues. This position requires thorough research and identification of various claim types in the MMIS and will also at times advise agency leadership and business partners of recommended changes or direction that help to meet the expectations of the agency in serving Oregonians who receive Medicaid services. This position also requires knowledge of both state and federal rules regarding Medicaid claims payments and all stages of Medicaid claims processing.
The position also has responsibility to give oversight and collaborative work in the Electronic Data Management System (EDMS). This position will also work in a cross-collaboration manner to help address other MMIS system issues and impacts, as needed. The claims business systems analyst serves as part of the Business Information Systems Section and specifically within the MMIS Business Services Unit.
OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.
The OHA mission is helping people and communities achieve optimum physical, mental, and social well-being through partnership, prevention and access to quality, affordable health care. OHA’s work is organized into three broad goals: Improve the lifelong health of all Oregonians, increase the quality, reliability, and availability of care for all Oregonians and lower or contain the cost of care so it is affordable to everyone.
What's in it for you?
Oregon Health Authority is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities. We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace.