Operations Business Analyst

$71,340 - $87,200/Yr

Careoregon - Seaside, OR

posted 2 months ago

Full-time
Remote - Seaside, OR
Insurance Carriers and Related Activities

About the position

The Operations Business Analyst at CareOregon is a pivotal role that serves as an advanced team resource, focusing on technical and process assessments. This position operates as a cross-functional team member and acts as a liaison between the assigned department, Information Systems (IS), and external vendors. The primary responsibilities include analyzing problems, defining business requirements, and recommending effective solutions. The Operations Business Analyst is responsible for overseeing the entire life cycle of development, from requirements gathering to implementation and ongoing support. This role also emphasizes the application of process improvement methods, leveraging organizational assets, and adhering to best practices. The specific areas of focus and specialization may vary depending on the department's needs. In this role, the analyst will perform existing systems analysis and design new systems, gather and define functional business requirements for both new and existing processes, and document business requirements, methodologies, systems flow, data flow, and functional system design. The analyst will translate business needs into actionable tasks for analysts and IS teams, collaborate with these teams to implement changes, and participate in User Acceptance Testing (UAT). Additionally, the analyst will monitor and improve the quality of reports produced, maintain project quality, and implement continuous process improvements. The role also involves developing ad-hoc reports using Microsoft applications, providing project status reports, and offering ongoing system support and guidance to department staff. The analyst will manage support requests through a ticket system, communicate the status of pending requests to stakeholders, and represent the business units' perspectives during projects and implementations. Building and maintaining productive customer relationships at all levels is crucial, as is engaging senior leaders as thought partners on occasion. The analyst will also present analysis results to executive sponsors as needed. Organizationally, the Operations Business Analyst is expected to perform work in alignment with CareOregon's mission, vision, and values, supporting the organization's commitment to equity, diversity, and inclusion. This includes fostering a culture of open-mindedness, cultural awareness, compassion, and respect for all individuals. The analyst will strive to meet annual business goals that support the organization's strategic objectives and adhere to relevant policies and compliance needs, while also performing other duties as required.

Responsibilities

  • Perform existing systems analysis and design new systems.
  • Gather and define functional business requirements for new and existing processes.
  • Document business requirements, business methodologies, systems flow, data flow and functional system design.
  • Translate business needs and requirements into actionable tasks for analysts and IS teams.
  • Collaborate with analysts and IS teams to implement changes; participate in User Acceptance Testing.
  • Monitor and improve the quality of reports that are produced.
  • Monitor, maintain and improve project quality and implement continuous process improvements.
  • Develop ad-hoc reports using Microsoft applications and provide analysis.
  • Provide project status reports as required.
  • Monitor and provide ongoing system support and guidance to department staff.
  • Monitor and resolve support requests using ticket system; escalate requests as necessary.
  • Communicate the status of pending requests to stakeholders.
  • Communicate the perspective of business units for projects and implementations.
  • Effectively develop, manage, and maintain productive customer relationships at all levels.
  • Engage senior leaders as thought partners on an occasional basis.
  • Present the results of analysis to executive sponsors as needed.

Requirements

  • Minimum 3 years' experience with Medicare and/or Oregon Medicaid.
  • Experience related to business analysis, process improvement, systems testing, and/or requirements gathering for systems implementations.

Nice-to-haves

  • Experience performing operations business analyses within the department's area of focus.
  • Claims department roles: 3 or more years' experience working directly with claims as a Biller (for a provider) and/or claims processor (for a health plan).
  • Experience working with QNXT, or similar Claims/Authorization processing platforms.
  • Exposure to business modeling tools (i.e., Visio) and various methodologies/frameworks such as CMMI, RUP, Six Sigma.

Benefits

  • Estimated hiring range $71,340 - $87,200 / year
  • 5% bonus target
  • Full benefits package including health insurance, dental insurance, and retirement plans.
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