Senior Business Analyst Consultant - Remote

Employer Industry: Healthcare Services

Why consider this job opportunity...
• Salary up to $190,400 annually
• Comprehensive benefits package including equity stock purchase and 401k contribution
• Opportunity for career advancement and growth within the organization
• Work remotely from anywhere within the U.S.
• Incentive and recognition programs available
• Supportive and inclusive company culture focused on health equity

What to Expect (Job Responsibilities):
• Coordinate with Market, Finance, Product, Medical Directors, and Healthcare Economics to identify and implement payment integrity opportunities
• Develop and implement payment integrity solutions through research and analysis of data and local business processes
• Lead program management for all California payment integrity services
• Create business cases to influence market partners and stakeholders for prioritizing new initiatives
• Ensure adherence to state and federal compliance policies and operational metrics

What is Required (Qualifications):
• 5+ years of experience in the healthcare industry
• 5+ years of experience working within MA, Medicaid and/or commercial lines of business
• Experience with product/vendor implementations and end-to-end process ownership for payment integrity programs
• Proficiency in Microsoft Office: Word, Excel, PowerPoint, and Visio
• Proven ability to manage competing priorities and engage with clients effectively

How to Stand Out (Preferred Qualifications):
• 1 or more of the following certifications: CPC, CPCO, AHFI, HCAFA, CFE
• Experience interpreting provider contractual agreements
• Experience managing a comprehensive portfolio of programs
• Proficiency in performing financial analysis/audit
• Comfortable with PMPM calculations and financial goal accountability

#HealthcareServices #RemoteWork #CareerGrowth #CompetitiveSalary #DiversityAndInclusion

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