The Business Analyst Senior reports directly to the Manager, Operations Compliance Program.
The Business Analyst Senior coordinates with members of the department and different Operations Business Areas within Operations and across all lines of business to identify problems and needs of the organization, collect, analyze, and document business requirements, and process improvement recommendations related to compliance and regulatory requirements. This individual participates in planning and implementation of proposed recommendations and system changes. .
Using knowledge of business practices, data availability and reporting applications, provide meaningful operational and performance metrics related to Operations Compliance including root cause analysis, compliance reporting, and trending data. With the goal of setting up reporting applications accessible to the business unit, daily work is a combination of new requests, maintaining existing reporting applications, and standard reporting.
The BA Sr. represents the division and the Plan when working with review agencies (OPP), accreditation agencies (NCQA and CMS), providers, high profile employer groups (GIC and USFHP). The BA Sr. needs to demonstrate strong professional judgment and apply risk management in highly escalated situations. They need to possess process re-engineering skills as well as to be able to understand root cause analyses.
The Business Analyst Sr. performs under general supervision, in which the manager provides continuing or individual assignments by indicating generally what is to be done, limitations, quality and quantity expected, deadlines and priorities. Additional, specific instructions are given for new, difficult, or unusual assignments. The Business Analyst Senior uses initiative in carrying out recurring assignments. The manager assures that work is technically accurate and in compliance with instructions or established procedures.
Information and Data Analysis
Problem Resolution and Implementation Support