Senior Operations Analyst

Full-time - Mid Level

Remote - Charleston, WV

1,001-5,000 employees

Professional, Scientific, and Technical Services

About the position

Public Consulting Group LLC (PCG) is seeking a Senior Operations Analyst to join our Quality Assurance team. This position plays a crucial role in ensuring the quality and accuracy of Medicaid cost settlement and supplemental payment work. The Senior Operations Analyst will assist with quality assurance processes, review and improve existing quality control mechanisms, and create documentation such as guides and standard operating procedures. The role involves monitoring and tracking data received from providers, completing quality assurance checks for assigned projects, and performing quality reviews of work completed by other staff members. Additionally, the analyst will assist in managing audits associated with school district providers, ensuring compliance and accuracy in all processes. In terms of leadership and supervision, the Senior Operations Analyst will organize and distribute work within the Quality Assurance team, providing supervision and support for junior staff. This includes contributing to decision-making and goal-setting for the team, ensuring that all members are aligned with the project objectives. The analyst will also be responsible for project management, collecting, managing, and documenting data flow on a large set of projects, monitoring progress, and communicating with partners to ensure assignments are completed within established timelines. Data management is another critical aspect of this role. The Senior Operations Analyst will handle larger-scale data management tasks, assess and transform Excel data to be compatible with pre-defined templates, and validate data management tasks performed by junior team members. The analyst will also conduct financial analysis of cost reports, including trend analysis and variance analysis, and perform desk audits of cost reports to validate data against supporting documentation. Client service is a key component of this position, requiring effective communication with internal clients regarding data discrepancies, missing information, and upcoming deadlines. The Senior Operations Analyst will provide first-line client support and escalate issues as necessary. The role may also involve special projects as assigned, contributing to the overall success of the Quality Assurance team and the organization as a whole.

Responsibilities

• Assist with quality assurance processes surrounding Medicaid cost settlement and supplemental payment work.
• Review and improve existing quality control and quality assurance mechanisms.
• Create and assist with documentation (e.g., guides, standard operating procedures, etc.).
• Assist management in establishing and promoting quality standards.
• Monitor and track data received from providers.
• Complete quality assurance checks for assigned projects.
• Perform quality review of work completed by other staff.
• Assist in managing audits associated with school district providers.
• Organize and distribute work within the Quality Assurance team.
• Provide supervision and support for junior staff.
• Contribute to decision-making and goal-setting for the team.
• Collect, manage, and document data flow on a large set of projects.
• Monitor progress both internally and communicate with partners to complete assignments within timelines.
• Review targets and timelines set forth by managers and assist the team with meeting them.
• Responsible for larger-scale data management tasks that touch many projects.
• Assess and transform Excel data to be compatible with pre-defined templates.
• Load data into pre-defined templates and confirm correct entry and interaction with automated functions.
• Identify and communicate data quality issues and summarize requirements for follow-up.
• Validate data management tasks performed by junior team members.
• Manage a queue of data management tasks with prompt delivery and clear communication.
• Conduct financial analysis of cost reports including trend analysis, variance analysis, and root cause data investigations.
• Gather and interpret cost and/or ratio data to identify variances and trends, create reports and perform advanced analysis when necessary.
• Perform 'desk audits' of cost reports, validating data submitted against supporting documentation.
• Assist internal client team with audit management (e.g., SOC, comprehensive audit reviews, etc.).
• Communicate with internal clients about data discrepancies, missing information, needed documents, upcoming deadlines, and status.
• Appropriately escalate issues within the team.
• Provide first-line client support via group email box and shared phone helpline.
• Other special projects as assigned.

Requirements

• Bachelor's degree is required.
• 7-10 years professional experience within a healthcare, financial or data environment.
• Advanced knowledge of Excel.
• Knowledge of SQL or other structured database tool preferred.
• Experience with or knowledge of Medicaid, Medicare, or Healthcare.
• Excellent verbal and written communication skills.
• Strong interpersonal, organizational, research, and time management skills.
• Ability to provide guidance and support to junior staff.
• Ability to manage projects and hit deadlines and other metrics.
• Ability to effectively and independently present information and respond to questions from project managers and other colleagues.
• Demonstrate a detailed and process-oriented approach to problem-solving.
• Demonstrate sound judgment in completing tasks and in seeking guidance when needed.
• Demonstrate a positive attitude and demeanor; showing initiative, enthusiasm, and strong willingness to learn.
• Demonstrate a commitment to deliver exceptional service for internal clients.
• Ability to report and track findings, review documentation, and notify upper-level management of key issues.
• Ability to embrace change and flexibility.
• Ability to juggle multiple assignments at once, seeking prioritization when necessary.
• Ability to work both in a team situation and autonomously.
• Proficiency in Microsoft Office products and applications.
• Ability to apply information learned to new projects and settings.
• Analytical skills, including the ability to analyze and organize data.
• Ability to work independently, within a team, and with multiple different people with different work styles.

Nice-to-haves

• Experience in performing or responding to audits and other quality assurance reviews within a Medicare or Medicaid setting.

Benefits

• Medical and dental care benefits
• 401k
• PTO
• Parental leave
• Bereavement leave