Senior Business Analyst - Meritain Health

About the role

This position focuses on researching and addressing the root causes of more complex customer and business issues that involve cross-functional processes. The research team is on point for navigating escalated organizational issues to provide guidance/direction to facilitate action and mitigate risk. There is a wide range of escalations from internal business units to include client management, claims, eligibility, network operations, customer service, audit, and Aetna.

Key Responsibilities

• Research, analyze, and recommend solutions on escalated issues.
• Act as subject matter expert with regards to unit workflows, systems, key processes, fiduciary responsibility and assemble all data used in making determinations for resolution.
• Ensure end-to-end traceability and document timelines.
• Develop and support thorough business case and member value analysis of potential solutions.
• Communicate compelling and concise results to empower decision making.
• Focus on risk mitigation, customer experience, and adherence to compliance requirements.

Required Qualifications

• 1+ years of experience working with business operations and data analytics.
• 1+ years of experience working in a healthcare and/or third party administrator business environment.
• 1+ years of experience utilizing Microsoft Suite: Excel, PowerPoint, Outlook.

Preferred Qualifications

• 2+ years of experience with data analytics reporting.
• 2+ years of Meritain system knowledge (DG and/or CSI).
• 2+ years of claims processing experience.
• Demonstrated problem solving, analytical, and decision-making skills.
• Strong communication & diplomatic skills across all levels.
• Collaboration skills.
• Strong & consistent performance.

Education

High school diploma or GED.

Pay

The Typical Pay Range For This Role Is $46,988.00 - $122,400.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.