Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Utilization Management Business Analyst will be accountable for development and maintenance of key resources for the utilization management team including training materials, workflows and reporting. This position will work closely with the Director of Utilization Management and cross-functional teams to document and refine utilization management processes in compliance with federal and state regulations as well as accreditation standards.
The Business Analyst job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Coordinate with Clinical Performance and Clinical Delivery team to define and document core program objectives, required outcomes and key performance indicators
- Work with cross-functional team to document and refine utilization management workflows and procedures
- Support and lead components of utilization management team training and development program
- Build reporting capabilities to monitor program performance
- Work with cross-functional team to ensure procedural compliance with state and federal regulations and accreditation
- Manage workplans and prioritize resources to meet key deliverables
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor's degree is required
- Five (5) or more years related experience required; preferably within a health plan or related field
- Experience in developing and maintaining process documents required
- Experience in interpreting data analytics, outcomes measures in health care and use of that data to drive change required
- Takes a creative approach to audience-facing reporting and documentation, establishing templates for use by others as needed
- Comfort with creating and managing timeline driven workplans, as well as creating process flow documentation that supports your work
- Ability to drive results in a collaborative environment, creating and leading cross-functional teams
- Excellent interpersonal communication and organizing skills to coordinate project activities
- Strong operational mindset and use data to draw insights; when applicable data is not available, you have the ability to gather all available information to support an approach and devise steps to measure the impact of your work for future iterations
- Experience in leveraging data and technology to solve problems or improve processes
- Experience in developing training resources, leading training programs to address business needs
- Bias toward action; sense of urgency, self-initiative, and ownership of work
- Superb written and verbal communication skills
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
- Some travel may be required.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.