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Business Analyst – Reimbursement

Remote

Job Overview: We are seeking a highly analytical and detail-oriented Business Analyst – Reimbursement to support financial sustainability and commercial insurance efforts at ESS. This role will focus on district outreach, reimbursement process optimization, grant support, and performance tracking. The ideal candidate will possess strong project management skills, data analysis expertise, and the ability to develop strategic insights that drive reimbursement efficiency and revenue growth. 

Key Responsibilities: 

Reimbursement & District Engagement: 

  • Support district outreach initiatives to improve reimbursement opt-in rates.
  • Build and maintain standardized outreach materials to streamline engagement with districts and families.
  • Update outreach materials as needed based on policy changes and evolving reimbursement approaches.
  • Facilitate workstream calls, outline action items, and problem-solve barriers to reimbursement. 

Process Optimization & Performance Tracking: 

  • Provide project management support for Headway and Medicaid stand-up and billing efforts. Develop and manage centralized tracking solutions to monitor reimbursement performance.
  • Track key KPIs and derive insights to identify performance improvement areas.
  • Conduct post-mortem analyses to address gaps in reimbursement tracking and optimize processes.
  • Lead ad-hoc analyses on reimbursement impact, such as claims yield and insurance coverage upon intake. 

Grant & Financial Support: 

  • Research and track grant opportunities for priority districts at risk, expanding, or new to reimbursement programs.
  • Assess the value of grant operations and partnerships by measuring the impact of grants secured for ESS services.
  • Develop models and calculators to set reimbursement targets and determine revenue potential based on district demographics. 

Reporting & Strategic Communications: 

  • Align with ESS leadership on materials required for Monthly Operating Reviews (MOR) and quarterly Board meetings.
  • Develop reports and analyses for MOR and Board presentations.
  • Maintain up-to-date district demographic data to support financial models and forecasting. 

Qualifications & Skills: 

  • Bachelor’s degree in Business, Finance, Economics, or a related field.
  • 3+ years of professional experience as a Business Analyst, Financial Analyst, Grant Analyst or similar role, preferred.
  • Strong proficiency in data analysis tools, including Excel (pivot tables, VLOOKUPs, financial modeling) and Salesforce.
  • Experience in project management, performance tracking, and financial forecasting.
  • Ability to analyze complex datasets and derive actionable insights to improve reimbursement and revenue performance.
  • Strong attention to detail, analytical thinking and problem solving skills.
  • Excellent communication and presentation skills, with the ability to develop materials for executive leadership.
  • Strong process/project management skills - Highly organized with the ability to manage multiple projects in a fast-paced environment.
  • Familiarity with grant compliance and regulatory standards, preferred. 

Why join Effective School Solutions?

  •  ESS is focused on addressing one of the biggest challenges our country is facing - - the mental health of our youth.
  • ESS is a dynamic organization with a strong record of accomplishment of innovation and growth.
  •  ESS provides staff with excellent career growth opportunities.
  • ESS offers staff competitive compensation and benefits offerings.
  • ESS values clinician voice and perspective and has multiple methods to give feedback and input on company decisions.

ESS is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment on the basis of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class.

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