Business Analyst III-Encounters & Claims Data at LA Care Health Plan

Job description

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review and documentation of functional business specifications. This position manages the requirements development process through the elicitation, analysis, specification and verification of multiple levels of requirements from an end-to-end perspective and supports the ongoing management of the requirements. This position develops report and analysis for the department. It is responsible in communicating and coordinating with IT on a day-to-day department related efforts. The Business Analyst III manages and coordinates the implementation and/or integration of products or new features for clients including client training and provides subject matter expertise (SME) and support of the department's inbound and outbound functions. This position acts as mentor to Business Analysts I/ II. Duties Develop functional and user acceptance test plans and scenarios. Coordinate functional and user acceptance testing by executing the testing strategy, scheduling resources and tracking test performance. Perform data analysis to support evaluation of system defects or to develop requirements for new functionality; assist in various system trouble shooting and balancing and correction efforts including analysis, verification and validation of issues and fixes. Coordinate activities including on-time delivery, testing and production moves. Collaborate with I.T. on all department related efforts, including submission of Service Requests and writing BRD's. Coordinate related data requests from internal departments, and/or assist I.T. with definition of criteria. Delegate data and reporting requests to business analysts. Facilitate collaborative system and data design sessions with the user community, technical architecture resources and development resources. Preparation of status updates to enterprise for distribution and communication. Work as a technical support and liaison to designated I.T. personnel to provide testing, support and feedback on enhancement requests and regular updates/releases; adhere to release schedules. Provide analytical support for critical corporate initiatives including business function support for system migrations and consolidations, significant business area process improvement projects and complex product installations. Demonstrate a high level of subject matter expertise in functional area to bridge business requirements and I.T. solutions; provide technical direction and ensure compliance with best practice solutions. Practice knowledge transfer and foster change management as the organization changes and new skills are required, focusing on team/individual development to be a valued contributor. Participate and contribute on the development/ creation of data models and interface design specifications. Support internal/ external stakeholder's roadmap and audits as needed. Oversee the business process support across multiple client engagements. Communication with internal/ external stakeholders for department's submission requirements. Review submission of data against established benchmarks and coordinate correction and improvement efforts. Monitor timely and accurate outbound data submission to state and federal recipients. Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed. Perform other duties as assigned. Duties Continued Education Required Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Experience Required: At least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, encounter processing. Skills Required: Competent to work at the highest technical level of most phases of systems analysis. Excellent verbal and written communication skills. Coaching, Mentoring and Teaching skills. Teamwork-focused/collaborative work style. Demonstrated ability to work successfully on large projects. Problem solving skills evidenced by demonstrated results in past positions. Ability to work under tight deadlines and handle multiple/detail-oriented tasks. Ability to influence at all levels of the organization. Proficient in Microsoft Office and Vizio. Preferred: Ability to work on other programs such as SharePoint and/ or OneNote Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and Grievances: This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call. This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including • Paid Time Off (PTO) • Tuition Reimbursement • Retirement Plans • Medical, Dental and Vision • Wellness Program • Volunteer Time Off (VTO)

Requirements

Must-haves

Participate and contribute on the development/ creation of data models and interface design specifications. Support internal/ external stakeholder's roadmap and audits as needed.
Perform other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.
At least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, encounter processing.
Competent to work at the highest technical level of most phases of systems analysis.
Excellent verbal and written communication skills.
Coaching, Mentoring and Teaching skills.
Teamwork-focused/collaborative work style.
Demonstrated ability to work successfully on large projects.
Problem solving skills evidenced by demonstrated results in past positions.
Ability to work under tight deadlines and handle multiple/detail-oriented tasks.
Ability to influence at all levels of the organization.
Proficient in Microsoft Office and Vizio.
Licenses/Certifications Required
Required Training
This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call.

Nice-to-haves

Education Preferred
Ability to work on other programs such as SharePoint and/ or OneNote
Licenses/Certifications Preferred
Physical Requirements
Additional Information

Application prep

Use the role’s language and application details while tailoring your materials.

Platform: successfactors
Effort: medium

Benefits

Benefits detected in the listing.

Dental

Vision

Pto

Paid Time Off

Wellness