UM Business Analyst

Job Description

HealthPartners is currently hiring for a UM (Utilization Management) Business Analyst. We are a nonprofit integrated care delivery and financing system based in Bloomington, MN. At HealthPartners, you ll find a culture where we live our values of excellence, compassion, integrity, and partnership. By working together, we will improve health and well-being, create exceptional experiences for those we serve and make care and coverage more affordable. We seek colleagues who wish to help advance diversity, equity and inclusion and foster an environment where everyone feels welcome, included, and valued.

This position is responsible for business systems production support activities for medical management and credentialing health plan administrative systems. Participates in the implementation of system software fixes/enhancements aligned with defined business objectives, serving as project leader on small to midsize projects. Development and maintenance of customized tools that support daily efficiencies for UM staff. Serves as a liaison between internal team members from assigned business operations and IS&T departments, as well as applicable system software vendors.

Accountabilities

• Serves as a subject matter expert for Utilization Management (UM) & Credentialing Service Bureau (CSB) applications, including working as a liaison between the business and IS teams, identifying and requesting system enhancements, developing requirements, testing, training, implementation of application installments and upgrades and day to day troubleshooting.
• Possesses in-depth knowledge of assigned systems/business operation functions including: system functional capabilities, data interfaces to/from other applications, system outputs, database structures, business processes and procedures, applicable national medical code sets, and relevant federal and state regulatory requirements.
• Serves as a primary business systems production support contact and subject matter expert to assigned internal business operations department(s) for questions related to system functionality capabilities and reporting of potential systems issues.
• Provides end user support and excellent customer service to 125+ staff in supporting and troubleshooting hardware and multiple software applications used by UM & CSB staff.
• Through application of analytical skills, computer technology knowledge, and health plan business operations knowledge, identifies potential opportunities to improve current automated or manual systems or processes or apply existing system capabilities to additional business operations.
• Reviews improvement suggestions with Manager, business operations staff and IS&T or, if applicable, the system software vendor.
• Performs necessary investigations related to reports of potential system issues. If issue is identified, develop problem resolution recommendation(s). This includes entry/maintenance of investigation information into systems tracking software.
• Reviews investigation findings and, if needed, proposed problem resolution recommendation(s) with Manager, business operations staff, IS&T and, if applicable, the system software vendor.
• Understanding interdependence among systems and consequences of change to each.
• Develops and distributes ad-hoc business reports through the use of an end user business reporting tool such as Crystal Reports or Business Objects.
• Maintains excellent working relationships with internal business customers, IS&T team members, department team members, project sponsors, and applicable system software vendors.
• Recommends priorities with limited resources.
• Identifies and presents opportunities for process improvement in order to increase data integrity and improve quality of reports.
• Maintains accurate inventory of hardware and software. Assist with defining hardware and software requirements and capital equipment needs to support departmental accountabilities.
• Coordinates set up of new hardware/software.
• Supports UM/CSB business continuity plan by maintaining emergency contact lists, floor plan with hardware and human resources, PC asset list.
• Coordinates new employee systems access and set up.
• Effectively and efficiently documents work plan status and coordinate progress with management teams, key contacts in other departments, vendors, and customers, when appropriate.
• Effectively and efficiently communicates to management staff regarding project activity, ensuring timely engagement in project deliverables and actively seeking user input to improve systems.
• Develops and implements departmental training programs in collaboration with the UM Training and Quality Manager.
• Participates in ongoing independent study and education to develop and maintain knowledge in the areas of applicable software systems and programs.
• Demonstrates responsiveness to and appreciation of constructive feedback and recommendations for personal growth and development.
• Supports HIPAA privacy and security standards.
• Demonstrates HealthPartners Core Values: Passion, Integrity, Teamwork and Respect
• Maintains confidentiality of information with the utmost rigor in accordance with HealthPartners corporate policies.
• Performs other duties as assigned.

Required Qualifications

• Bachelor s degree in Computer Science, Business, Healthcare or related field or equivalent in college courses and job experience.
• Minimum of 3 years work experience as a business or systems analyst or related experience
• Demonstrated effective project management skills in achieving key project timelines and deliverables in health care.
• Ability to plan, organize and prioritize work effectively, including the flexibility to accommodate frequent changes.
• Demonstrated effective communication skills with cross-functional departments and external vendors.
• Excellent written and verbal communication skills, including facilitation and presentation skills in technical and non-technical vernacular.
• Demonstrated strong analytical and problem-solving skills related to software system-based processes.
• Working knowledge of various reporting tools and strategies.
• Strong change management skills.
• Ability to interact and maintain relationships with medical and non-medical users in a customer service/liaison role.
• High degree of initiative and ability to work independently and within a group.
• Ability to deal with ambiguity and changing priorities.
• Strong customer/client service orientation.
• Ability to take responsibility for one s own performance and attitude on the job.
• High degree of initiative.

Preferred Qualifications

• Previous experience in a health care setting in utilization management/utilization review, administrative/information systems, or similar experience.
• Experience in working with health care information systems
• Experience with Oracle and/or Microsoft Access databases.
• Knowledge of HealthPartners systems and applications.

Decision-making

This position is responsible for developing and recommending the type, scope and general direction for database, reports, and basic department desktop hardware/software (i.e., Project Office, Visio, etc.) and QUI applications. Decisions regarding upgrades or changes to hardware or software will be approved by the manager or director. Decisions regarding overall department direction and long-term planning will be made by the director.

HealthPartners is recognized nationally for providing outstanding care and experience for patients and members. We offer an excellent salary and benefits package. For more information and to apply go to

Additional Information

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.