Operations Business Analyst IV - Claims adjudication and/or Facets claims adjudication (preferred)
Core
Oversees business analysis initiatives to drive operational excellence and efficiency of existing processes and systems, leading cross-functional process improvements and aligning solutions with organizational strategy.
Role type
Senior Operations Business Analyst (Healthcare Claims)
Builds
Operational readiness frameworks, policy documentation, and process improvement initiatives for claims lifecycle management.
Domain
Healthcare insurance and managed care operations
Deliverable
dashboards & analysis
Required skills
Process redesign, cost-benefit analysis, ROI assessment, stakeholder liaison, policy management, change management, strategic planning, data analysis, pattern identification, trend analysis, testing and validation, mentoring
Preferred skills
Six Sigma, performance improvement
Technologies
None stated
Responsibilities
Lead end-to-end process redesign initiatives; act as primary liaison between stakeholders, technical teams, and executive leadership; manage and maintain policy and performance of claim lifecycle; advise executive leadership on change management strategies; perform cost-benefit and ROI analyses; mentor Business Operations Analysts/Associates
Seniority
Senior, hands-on IC