Business Analyst I

Overview

The Business Analyst will be responsible for driving results by supporting the Clinical Chart Validation (CCV) Appeals team in identifying enhancements, pinpointing key areas for improvement, and implementing medium-to-large-scale projects.

Responsibilities

• Work closely with business partners to understand current operations and how current and future systems may improve productivity and quality.
• Conduct analysis to determine the best approach for addressing business problems and opportunities, including process improvements, system enhancements, and improvements to CCV quality.
• Apply and utilize business process modeling methods to ensure business outcome-based deliverables in a way that can be readily used as input to Product Delivery teams and executive decision-making by both line of business and IT partners.
• Facilitate future-state process and visioning sessions with business partners.
• Define measurable process improvement objectives and participate in grooming features sessions.
• In collaboration with the Appeals Manager, define project requirements and actively support the implementation of process improvements.
• Ensure product satisfies the customer/end-user requirements by actively representing the business users in product testing and evaluation through mapping product enhancement to business process change.
• Translate business requirements into use cases and actionable deliverables.
• Work with data teams to improve appeal reporting accuracy and usability.
• Develop dashboards or reporting requirements for leadership.
• Reduce manual steps and rework in appeal processing.
• Improve intake, routing, and adjudication workflows.
• Spot inconsistencies in appeal handling across teams.
• Conduct ad hoc research and support special projects as assigned.

• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

 

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change.

Qualifications

• Strong relationship-building skills and customer orientation. Proven ability to collaborate with business partners to define needs, address issues and answer questions.
• Ability to interact with business users in a sensitive and diplomatic manner while constructively challenging existing procedures and fostering collaboration on project goals.
• Ability to translate complex business needs into clear, actionable solutions.
• Consistent and effective critical thinking skills required.
• Critical thinking and problem-solving skills with strong attention to detail.
• Strong organizational skills with a commitment to thorough documentation
• Strong written and verbal communication skills with remote and international resources.
• Professional demeanor with the ability to use appropriate language, tone, style, and structure in oral and written communications.
• Positive and helpful demeanor in interactions with all internal/external stakeholders.
• Ability to manage multiple priorities, meet deadlines, and work with urgency.
• Ability to maintain strict confidentiality in all communications involving sensitive information.
• Self-driven and adaptable, with the ability to thrive in a fast-changing environment.
• Must possess intermediate skills with MS Excel and Power BI and be proficient with Microsoft Office Suite (Word, Outlook, Visio, PowerPoint).
• Ability to work effectively both independently and collaboratively within a matrixed, cross-functional environment.

• In addition, the Appeals Business Analyst should possess strong communication skills and be adept at managing multiple priorities. Attention to detail and the ability to translate complex business requirements into actionable solutions are essential for success in this role.

MINIMUM QUALIFICATIONS:

 

• Bachelor’s Degree required.
• Healthcare Systems and Operations experience preferred.
• 5 years’ experience with Business Process development.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions: