Business Analyst II- Capitation
Core
Translate business needs into application software requirements for capitation and behavioral health reimbursement policies.
Role type
Business Analyst II (Healthcare Capitation)
Builds
Application software requirements for capitation configuration and policy implementation
Domain
Healthcare / Health Insurance / Capitation
Deliverable
production ML models | product features
Required skills
Capitation configuration, Behavioral health reimbursement policy rules, Provider contract analysis, System requirements analysis, Trend analysis, SQL, Excel (pivots, formulas, Power Query)
Preferred skills
GBD Facets capitation configuration, Healthcare operations knowledge, Provider contract amendments
Technologies
SQL, Excel, GBD Facets
Responsibilities
Analyze and support multiple markets serving as primary analyst for provider questions and payments; Configure capitation for new contracts and amendments; Test new implementations and expansions; Determine optimal means to meet business needs; Collaborate with programming staff on system design and testing; Act as liaison with software users.
Seniority
Mid-level, hands-on IC
