Appeal and Grievance Business Analyst - Macpower Digital Assets Edge Private Limited (MDA Edge)
Los Angeles, CA 90017
About the Job
Job Summary:
- The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review and documentation of functional business specifications.
- This position manages the requirements development process through the elicitation, analysis, specification and verification of multiple levels of requirements from an end-to-end perspective and supports the ongoing management of the requirements.
- This position will develop report and analysis for the department.
- It is responsible in communicating and coordinating with IT on a day-to-day department related effort.
- The Business Analyst III will manage and coordinate the implementation and/or integration of products or new features for clients including client training and provides subject matter expertise (SME) and support of the department's inbound and outbound functions.
- This position will act as mentor to Business Analysts I/ II.
Key Requirements of this position:
- QNXT Experience.
- Healthcare industry.
- Proven analytical/technical aptitude evidenced by at least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, Encounter Processing.
- Bachelor Degree.
- Managed Care experience
Duties:
- Develop functional and user acceptance test plans and scenarios.
- Coordinate functional and user acceptance testing by executing the testing strategy, scheduling resources and tracking test performance.
- Perform data analysis to support evaluation of system defects or to develop requirements for new functionality; assist in various system trouble shooting and balancing and correction efforts including analysis, verification and validation of issues and fixes.
- Coordinate activities including on-time delivery, testing and production moves.
- Collaborate with I.T. on all department related efforts, including submission of Service Requests and writing BRD's.
- Coordinate related data requests from internal departments, and/or assist I.T. with definition of criteria.
- Delegate data and reporting requests to business analysts.
- Facilitate collaborative system and data design sessions with the user community, technical architecture resources and development resources.
- Preparation of status updates to enterprise for distribution and communication.
- Work as a technical support and liaison to designated I.T. personnel to provide testing, support and feedback on enhancement requests and regular updates/releases; adhere to release schedules.
- Provide analytical support for critical corporate initiatives including business function support for system migrations and consolidations, significant business area process improvement projects and complex product installations.
- Demonstrate a high level of subject matter expertise in functional area to bridge business requirements and I.T. solutions; provide technical direction and ensure compliance with best practice solutions. Practice knowledge transfer and foster change management as the organization changes and new skills are required, focusing on team/individual development to be a valued contributor.
- Participate and contribute on the development/ creation of data models and interface design specifications.
- Support internal/ external stakeholder's roadmap and audits as needed
- Oversee the business process support across multiple client engagements.
- Communication with internal/ external stakeholders for department's submission requirements.
- Review submission of data against established benchmarks and coordinate correction and improvement efforts.
- Monitor timely and accurate outbound data submission to state and federal recipients.
Required Skills:
- Competent to work at the highest technical level of most phases of systems analysis.
- Excellent verbal and written communication skills.
- Coaching, Mentoring and Teaching skills.
- Teamwork-focused/collaborative work style.
- Demonstrated ability to work successfully on large projects.
- Problem solving skills evidenced by demonstrated results in past positions.
- Ability to work under tight deadlines and handle multiple/detail-oriented tasks.
- Ability to influence at all levels of the organization.
- Proficient in Microsoft Office and MS Visio.
Source : Macpower Digital Assets Edge Private Limited (MDA Edge)
