Senior Business Analyst, Government Programs Operations Claims & Encounters

About the role

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

To learn more, visit www.judi.health.

Position Summary

The Business Analyst provides support gathering and documenting business and reporting requirements that align with state and federal guidelines. This individual will analyze complex problems and issues using available information from both internal and external sources. Other responsibilities will include – creating specifications documents for business processes, reports, data extracts, and analyses based on business needs. Identify and interpret trends in datasets to find possible outliers or patterns that can be used to drive process improvements. Collaborates with internal and external cross-functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, clinical operations) to design, refine, automate, and maintain operational capabilities.

Position Responsibilities

• Maintains documentation of existing business processes and updates as necessary
• Identifies new opportunities for process development and improvement
• Manages stakeholder requests and analyzes business processes and data to develop subject matter expertise
• Collaborates with cross-functional teams to resolve data and process issues
• Supports analytical and problem-solving functions by defining and documenting specifications pertinent to all departmental processes
• Analyzes business workflow and system needs for conversions and migrations to ensure compliance with government regulations
• Develops and sets up performance metrics for stakeholder distribution
• Performs root cause analysis of government data processing and submission issues; develops recommendations based on data and industry knowledge

Minimum Qualifications

• 3+ years of healthcare experience
• 3+ years of business process analysis, preferably in healthcare
• 3+ years of experience with Government Exchange programs
• Demonstratable knowledge of SQL, Excel, and flow-charting tools
• Experience with implementation/project management
• Experience working with cross-functional teams
• Extremely flexible, highly organized, excellent communication and able to shift priorities easily
• Attention to detail & commitment to delivering high-quality work product
• Comfort or experience in a fast-paced, growing environment
• Intellectual and professional curiosity
• Familiarity with the agile framework/Certified Scrum Product Owner preferred
• Bachelor’s degree in Business Administration, Data Analytics, Computer Science or 3+ years of relevant experience

Pay

• New York, NY: $135,000 - $146,000 USD
• Denver, CO: $125,000 - $135,000 USD
• Charlotte, NC: $115,000 - $125,000 USD

Benefits

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

Equal Opportunity Employer

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Contact Information

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.

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