Operations Reporting Analyst

About the Role

Under the general supervision of the Operations Reporting Analyst Supervisor, the Analyst is responsible for the completion of the Service Coordination components of the OLTL OPS Reporting process. This includes improving and completing existing state-mandated reporting requirements while maintaining a high level of accuracy, integrity, and timeliness of data reports. The role involves developing and maintaining a complete understanding of all data sources available for reporting CHC Service Coordination data and ensuring all regulatory reporting requirements are met accurately and on time. Failure to do so may result in financial penalties, decreased client satisfaction, and compromised relationships with state or regulatory agencies.

Performs data verification through trending, benchmarking, or other analyses to ensure data integrity. Maintains electronic and paper documentation supporting the completion of each report for each reporting period within departmental guidelines. Works cooperatively with other team members and across departments, including Regulatory Reporting, utilizing a team approach.

Develops and maintains strong knowledge of business practices and the managed care industry, applying this knowledge to determine data and report solutions. Uses independent judgment, with supervisory guidance as necessary, to ensure reporting is completed accurately and efficiently. Identifies and researches issues or problems that may compromise data accuracy or integrity, analyzes Service Coordination data anomalies, validates results, and provides explanations for variances and changes.

Participates in process evaluation and improvement, communicating with management and stakeholders to determine appropriate courses of action prior to enacting changes in reporting processes. Assists in other tasks or reporting as assigned.

Responsibilities

• Complete all regulatory reporting requirements accurately and on time to avoid financial penalties and maintain client satisfaction.
• Develop and maintain a thorough understanding of all data sources for CHC Service Coordination reporting.
• Perform data verification through trending, benchmarking, or other analyses to ensure data integrity.
• Maintain electronic and paper documentation for each reporting period within departmental guidelines.
• Work cooperatively with team members and across departments, including Regulatory Reporting.
• Apply knowledge of business practices and the managed care industry to determine data and report solutions.
• Use independent judgment to ensure accurate and efficient reporting, with supervisory guidance as needed.
• Identify, research, and resolve issues that may compromise data accuracy or integrity.
• Analyze Service Coordination data anomalies, validate results, and explain variances or changes.
• Participate in process evaluation and improvement, communicating with management and stakeholders.
• Assist in other tasks or reporting as assigned.

Requirements

• Bachelor’s Degree or equivalent experience required.
• Basic working knowledge of business computer programs, applications, and systems.
• Basic understanding of business practices and ability to extract and manipulate data from various sources.
• Strong communication (written and verbal), analytical, and problem-solving skills.
• Excellent organizational skills and ability to identify, research, investigate, and document findings.

Skills

• Advanced to expert proficiency in Microsoft Excel strongly preferred (candidates may be required to complete an Excel assessment as part of the interview process).
• Strong data analysis, reporting, and data validation skills.
• Proficiency with Excel functions including XLOOKUP/VLOOKUP, INDEX/MATCH, Pivot Tables, SUMIFS, COUNTIFS, IF statements, Conditional Formatting, Data Validation, and Power Query.
• Experience analyzing large datasets, identifying trends and anomalies, and ensuring data accuracy and integrity.
• Ability to manage multiple reporting deadlines in a fast-paced, regulated environment.

Benefits

• Flexible work solutions including remote options and hybrid work schedules.
• Competitive pay.
• Paid time off, holidays, and volunteer events.
• Health insurance coverage for you and your dependents starting Day 1.
• 401(k) retirement savings plan.
• Tuition reimbursement.

About the Company

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. AmeriHealth Caritas is seeking talented, passionate individuals to join our team and help build healthier communities.