Hi,

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Business Analyst - HealthCare

2-3 months

Nashville, TN

Client is currently looking for a Business Analyst for a short term (2-3 Month Contract) for one of our clients. I am looking for strong functional BA skills and strong knowledge of Medicare/Medicaid claims processes and strong knowledge of the enrollment process. This individual will also need to have strong flow-charting skills (ex: Visio, etc.).

Must haves are:   Visio/Flowcharting, Managed Care experience, and Good/Clear Communication.
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Primary Function:

Under administrative direction, conducts research and analytical studies of a technical and specialized nature on critical issues or developments which have a significant impact on the policies, goals, objectives, and operations of Medicare Enrollment and Reconciliation Department: serves as a member of the management team in the planning andimplementation of major departmental changes; develops strategies for initiating collaborative efforts with other  departments and markets to coordinate and integrate eligibility processing and reconciliation; performs other related duties as required. Some travel may be required.

Projects typically have a significant impact on the policies and operations of Enrollment with significant eligibility reconciliation and processing impacts. Work assignments require a significant amount of independent judgment in analyzing and interpreting complex information.

Researches, analyzes, and interprets complex information such as CMS regulations, demographic, and fiscal developments and trends to aid management in making decisions to resolve critical issues or problems; based on analysis, develops theories and policies, and formulates strategies for action on critical issues such as major program changes; advises Enrollment Director, Vice President of Medicare Data Quality Operations, and Executives
on the potential impact of CMS developments and necessary programmatic changes; develops strategies for initiating collaborative efforts and coordinating and integrating eligibility processing; tracks department budget and makes recommendations for potential cost saving initiatives; conducts other management studies of any magnitude or scope as required.

Researches information using a variety of resources; prepares and presents comprehensive narrative and statistical reports of findings, including charts and graphs: develops and prepares policy statements and responses to proposed CMS regulations; provides staff support to various committees within and outside the department, and provides technical information to committee members to explain changes or the projected consequences of such issues as CMS regulatory changes.

Makes presentations before Enrollment Director, Vice President of Medicare Data Quality Operations, Executives, and employees of other departments to educate them on major changes impacting operations.

Experience

BA or BS Degree or equivalent work experience
3-5 years in a managed care environment
Experience in and knowledge of Medicare Enrollment policies and procedures
Strong written and verbal communication skills
Proficient in MS Office products
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 For Further questions please feel free to call me at 678-578-4534

Thanks and Regards

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SHA S.K | Phone: 678-578-4534 | Fax : 678-904-5234
Virtue Group,  5755 North Point Parkway, Suite 85, Alpharetta, GA 30022 |
www.virtuegroup.com

A WBENC Certified Company