Overview
Works directly with management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative solutions to meet those needs. Gathers requirements, performs analysis, designs new or enhanced systems to meet operational, business, and clinical needs. Collaborates with Business Unit and/or Project Manager on assigned projects. Works under general supervision.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, including Medical, Dental, Vision, Life, and Disability
- Employer-matched retirement savings funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, CEU credits, and advancement opportunities
What You Will Do
- Maintain analysts' library of resources, including pertinent books and articles on information systems.
- Understand VNS Health Plans' strategic business objectives and operations, and articulate business issues and data collection methodologies.
- Provide data collection and analytical support, monitor projects, and create reports.
- Participate in interdepartmental work groups for process improvement.
- Assist in designing and delivering presentations on project status and outcomes.
- Monitor new and existing process designs to measure operational effectiveness.
- Perform financial impact analysis for retro compensation grids based on amendments or new state rates.
- Act as liaison between claims, providers, and internal departments.
- Manage workload and inventory according to departmental SLA.
- Identify and create global claim projects and review claims disputes within SLA.
- Report dispute trends and participate in special projects as assigned.
Qualifications
Education:
- Bachelor's Degree in Business or related discipline or equivalent work experience required.
- Master's Degree in Business Administration, Public Administration, or related field preferred.
Work Experience:
- At least one year with a managed care organization on business transformation required.
- Two years experience with FACETS, SQL, OBIEE, Power BI, Tableau, MicroStrategy, project management, SDLC, relational databases, HIPAA guidance, industry standards for EDI, preferred.
- Strong command of Microsoft Office and web technologies required.
- Effective communication, consulting, analytical skills, and ability to work with diverse stakeholders required.
- Ability to work autonomously and collaborate with senior leaders required.
- Understanding of NYS, CMS, Medicaid reimbursement guidelines, APG, APC, DRG required.
Pay Range
USD $63,800.00 - USD $79,800.00 /Yr.
About Us
VNS Health is a leading nonprofit home and community health care organization with over 130 years of innovation. We serve more than 43,000 neighbors with compassionate care, data analytics, and comprehensive health solutions, primarily in New York and beyond.
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