Lead Business Analyst (Health Care Operations)

Lead Business Analyst (Health Care Operations)

New York, New York

• Identify and analyze business processes and associated systems in order to identify opportunities for improvement. Develop workflow/process improvements designed to increase operational efficiencies. Maximize standardization where possible to eliminate redundancies, waste and inefficiencies.
• Lead and manage projects as assigned. Partner with line management to develop and implement plans, practices and programs that improve efficiency.
• Drive development of business requirements associated with necessary system changes within the financial recovery and claim resolution space.
• Serve as SME and resource in the implementation of recommended solutions.

Responsibilities:

• Identify opportunities to improve EmblemHealth's financial recovery processes, claims processes, systems and workflows: reduce gaps in performance by increasing operational efficiencies and standardization of processes of related functionalities.
• Work with financial recovery and claim resolution areas to develop workflows that enhance process standardization efforts.
• Collaborate with and influence internal business partners to drive change and process improvement with the ultimate goal of decreasing inventory receipts in the financial recovery and claim resolution spaces.
• Develop business cases and presentations to further influence and drive toward this goal.
• Execute improvement of business processes by leading and/or managing projects chartered to optimize financial recovery and/or claim resolution business processes.
• Represent financial recovery and claim resolution teams in corporate projects and initiatives including, but not limited to, attendance at regularly scheduled meetings, development of business requirements, providing subject matter expertise, review of test plans and user acceptance testing results.
• Work directly with financial recovery and claim resolution management to understand current business workflows and needs. Provide recommendations to department management on process improvement or system solutions to drive efficiency.

Requirements:

• Bachelor's Degree required, preferably in Healthcare Administration, Business Administration or Finance; additional years of experience or specialized training/experience may be considered in lieu of educational requirement
• Lean "Facilitator" or Green Belt Certification preferred
• 4 - 6 years' related work experience in health insurance, business analysis, financial recovery and/or collections in business analytics and/or project management role required
• Excellent verbal, written communication and interpersonal skills required
• Ability to influence required
• Strong knowledge of claim processing policies and procedures required
• Ability to understand and break down business processes and system function to identify opportunities for improvement required
• Strong analytical and problem-solving skills required
• Strong Interpersonal and teamwork skills required

Additional Information

• Job Type: Standard
• Schedule: Full-time
• Employee Status: Regular
• Requisition ID: 22098
• Hiring Range: $85,000-$105,000