Business Systems Analyst-100% Remote - ConsultNet

Business Systems Analyst – Healthcare
Remote - U.S.
$80,000-$110,000/yr
Due to operational requirements, we are only able to consider candidates currently residing in the following states:
Arizona, Florida, Georgia, Idaho, Missouri, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.
 

Job Description:
ConsultNet is searching for a Business Intelligence Analyst. The business intelligence analyst will conduct thorough data analysis, design, and implement analytic programs, generate reports, and collaborate with various teams to ensure we have the data necessary to optimize our resources, product performance and maximizing our market share. To succeed in this position, you must be driven and thrive in a fast-paced environment. Combine these reports with subject-matter expertise to deliver coherent, insightful takeaways and advice. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function.

Responsibilities:

• Accounts Receivable support – Provide data analytic support and automation on reconciliation of eligibility files, capitation payments, repricing payments, etc.
• Accounts Payable support – Enhance reporting of Medical Loss Ratio and Profit/Loss trends through the ingestion of multiple data sources, ensuring data is clean and normalized for accurate reporting.
• Utilization Management support – Build data models for appropriate monitoring of outliers; billing integrity; Fraud, Waste, and Abuse (FWA); Special Investigation Unit (SIU)
• Business Development support – Build models to enable proper pricing for proposals on a capitated or fee for service bases, analyzes potential client claims data, provider network adequacy, provider contract fee schedule and applies logic to pricing models for necessary adjustments.
• Meet with leadership to gather information regarding the goal of a project and define requirements for reporting and monitoring at a level appropriate for the audience.
• Collaborate with Operations leadership to develop departmental reporting for monitoring user productivity using complex backend activity logs.
• Interact with internal clients to evaluate products and performance using both internal and external data sources.
• Always maintain objectivity to ensure reporting, processes and products are relevant.
• Make data-driven decisions and recommendations.
• Articulately and concisely explain the implications of complex data including identification of inaccurate replication, misrepresentation of data, bad joins, production structure and input errors.

Required Skills:

• Minimum of 5 years' experience working in analytics or relevant position in the Healthcare,
• Medical Insurance or Transportation industry
• Solid computer skills, including The Microsoft Office Suite, most specifically MS Excel, MS Access, and web-based applications.
• AWS/Redshift is desirable.
• Significant work experience in SQL Coding
• Significant experience with Data visualization tools like Power BI, or Quicksight
• Keen eye for details and aptitude for working with data and data validation.
• Highly accurate and thorough in all tasks
• Exceptional organizational, prioritization of tasks, and presentation skills
• Outstanding written, verbal, and interpersonal skills
• Strong problem-solving skills and an analytical mind
• Proven experience as a collaborative team player
• Able to thrive in a fast-paced, deadline-driven environment.

Welcome to ConsultNet and the family of companies, Tekne, SaltClick, TechBridge, and OmniMedia. As a premier national provider of technology talent and solutions, our expertise spans across project services, contract-to-hire, direct placement, and managed services both onshore and nearshore.

Celebrating more than 25 years of partnership with a diverse client base, we've crafted rewarding opportunities for our consultants, fostering high-performing teams that deliver impactful results.

Over the last few years thousands of consultants have found their calling with us in roles that have made a meaningful impact on their lives, enhanced their career, challenged them, and propelled them towards achieving their personal and professional goals. At the ConsultNet family of companies, we believe effective communication is crucial in aligning the right job with your unique skills and professional aspirations. To us, it's all about the personal approach we take and the values we uphold.

Our comprehensive service offerings cover a wide range of technology positions across key markets nationwide. Client more at www.consultnet.com .

We champion equality and inclusivity, proudly supporting an Equal Opportunity Employer policy. We welcome applicants regardless of Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other status protected by law.