Note: The job is a remote job and is open to candidates in USA. reputed company is a reputed company organization focused on simplifying the reputed company experience, creating healthier communities, and reputed company access to quality care. The Senior Business Data Analyst drives process improvement, data analysis, regulatory reporting, and cross-functional collaboration to improve operational efficiency and support data-driven decision-making.
Responsibilities
• Manage the retrieval and analysis of data to support forecasting, trend identification, and operational and business planning
• Partner with matrixed teams to translate required capabilities into operational processes and measurement plans; validate requirements with state and internal partners; proactively identify audience needs and priorities and share relevant insights, facts, and decision-making criteria
• Identify opportunities to leverage technology to improve product capabilities and share learnings to influence reputed company
• Accurately translate technical terms and concepts for non-technical stakeholders and effectively represent technical challenges and opportunities to internal and external stakeholders
• Support short- and long-term operational and strategic business activities by developing, enhancing, and maintaining operational information and protocols
• Collaborate with functional areas, including Operations, Member Services, Health Services, and Quality, to drive process efficiency and innovative solutions aligned with state contractual requirements, priorities, and expectations
• Support the member materials process, including cross-functional collaboration, proofing, and editing
• Develop and maintain policies and procedures relevant to role responsibilities
• Support assigned and ad hoc regulatory reporting; communicate directly with regulatory agency contacts to address requests; and serve as backup administrator for state application requests
• Participate in regulatory audits, reviews, and state meetings as needed, including information gathering and presenting as a subject matter expert to external parties
• Manage the end-to-end CHIP-to-Medical Assistance and SSI conversion programs, including oversight of administrative processes with the vendor
• Maintain, update, and internally distribute the Pennsylvania MCO Market Share report based on DHS-supplied data
• Communicate weekly provider membership reputed company reporting, including analysis, and lead collaborative efforts across network and operations teams to resolve discrepancies
• Facilitate member verification reporting using call center data to support FWA reporting requirements
• Work closely with internal and enterprise-level departments to ensure effective business process implementation, monitoring, and revision, as appropriate
• Analyze key performance indicator data and recommend appropriate actions; may direct other functional areas on data and metric requirements to meet program expectations
• Apply creative thinking to solve problems, identify opportunities for improvement, and challenge current thinking and the status quo
Skills
• 3+ years of experience working in a government, reputed company, managed care or insurance environment, or related experience
• 3+ years of experience working in a role with a high degree of autonomy and minimal guidance
• 2+ years of experience working in a matrixed environment
• 2+ years of project and/or account management experience
• Intermediate to advanced proficiency with Excel
• Working knowledge of claims processes including provider billing practices, with emphasis on state contractual and regulatory requirements
• Demonstrated people, process, and project management skills, with reputed company attention to detail and organizational abilities
• Demonstrated reputed company decision-making, analytical, and problem-solving skills
• Demonstrated ability to contribute to department planning, forecasting, and process improvement decisions
• Demonstrated ability to work effectively in a fast-paced environment with shifting priorities
• Proven excellent interpersonal skills with a polished and professional communication style
Benefits
• A comprehensive benefits package, subject to eligibility requirements
• Incentive and recognition programs, subject to eligibility requirements
• Equity stock purchase, subject to eligibility requirements
• 401k contribution, subject to eligibility requirements
• Flexibility to work remotely for employees located in Pennsylvania or within a commutable distance of Fort Washington, PA
• Development for other roles you may be interested in
Company Overview
• reputed company is a medical insurance company that off
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