About the job Business Analyst, Quality & Business Performance About the Business Analyst, Quality & Business Performance: The Business Analyst will be responsible for analyzing, documenting, and optimizing business processes within the operational performance teams. This role requires a strong understanding of healthcare operations, data analysis, and project management. The ideal candidate will work closely with stakeholders to identify opportunities for improvement and implement effective solutions based on data-driven trends and analyses. This position is eligible for remote work, but quarterly travel will be required to the corporate office located in Tampa, Florida. Business Analyst, Quality & Business Performance Essential Functions and Responsibilities:
- Design, build, and conduct data analysis across multiple datasets to identify trends, patterns, and opportunities for improvement in healthcare processes.
- Assist in the design and implementation of healthcare IT systems and solutions, ensuring they meet business needs and regulatory requirements.
- Create and deliver presentations and reports to communicate findings, recommendations, and project updates to stakeholders.
- Facilitate workshops and meetings with stakeholders to identify and prioritize business needs and solutions.
- Monitor and evaluate the effectiveness of implemented solutions and make adjustments as necessary.
- Develop and maintain detailed business process documentation, including workflows, data models, and use cases for all analytics performed.
- Stay up-to-date with industry trends, regulations, and best practices in healthcare business analysis.
Business Analyst, Quality & Business Performance Minimum Qualifications:
- 3+ years of experience in healthcare operations, authorization or claims, with a focus on quality and business performance processes.
- Bachelors degree in Business Administration, Healthcare Management, Information Systems, Health Informatics, or a related field, or 7+ years direct, applicable experience in lieu of a degree.
- Strong analytical and problem-solving skills with the ability to interpret complex data and provide actionable insights.
- Proficiency in data analysis tools and software, such as Excel, Tableau, Power BI, SQL, and data visualization tools.
- Knowledge of healthcare regulations, standards, and best practices, including authorization and claims editing systems.
- The ideal candidate is analytical, detail-oriented, and exhibits systems thinking to troubleshoot and improve validation workflows. Experience with healthcare analytics platforms and tools.
Business Analyst, Quality & Business Performance Preferred Qualifications:
- Masters degree in Health Informatics, Information Systems, Healthcare Administration, or a related field.
- Demonstrated expertise in clinical claims editing systems.
- Strong knowledge of regulatory requirements and compliance standards in healthcare, including HIPAA, CMS guidelines, and payer-specific rules.
- Proven track record of process improvement, automation in quality or business performance.