Senior Business Operations Analyst - Medi-Cal Rx

This position is a critical liaison between Non-Clinical Operations, Finance and Analytics. Leads and supports various business operations initiatives, that are cross-functional and in support of continuous process improvement and quality improvement management. Builds analyses and reports using persuasive data visualization and oral and written communication skills that can translate complex analytic findings and concepts to a varied audience of users. This position serves a key role in planning, directing and measuring the overall performance of large scale, cross-departmental projects, and critical day-to-day performance metrics. This position provides technical and reporting expertise, process improvement consultation, and works closely with leadership and the executive team on measuring and analyzing program and project performance.

• Coordinates with business users to define business processing activities, data availability, and requirements, to implement operational procedures.
• Analyzes business processes and assists in implementing recommendations with financial and operational emphasis.
• Collects, analyzes and interprets both qualitative and quantitative data; performs analytical and root cause analyses.
• Performs exploratory data analysis and aggregation from various data sources, including authorization, claims, phone system, and HR system.
• Analyzes current operations processes to determine areas to improve operational effectiveness and efficiency, proposes solutions for current and future needs.
• Designs, documents, develops and rolls out operational performance analyses using a variety of computing tools. Creates analytic views on operational performance to help management interpret historical results.
• Explains prior performance and utilizes to forecast forward.
• Partners with Work Force Management to create and adapt flexible operations staffing models from workflow analysis that will allow for change in membership, program efficiencies and expansion of responsibilities.
• Performs budget versus actual analysis on subjects such as but not limited to: overhead, demand/utilization, and operational performance.
• Performs ad hoc analyses that will vary in duration and complexity.
• Creates user friendly tools to help measure, manage, and report the effectiveness of customer experience management initiatives.
• Understands and creates documentation for operational performance metrics. Participates in defining issues to be studied as well as the methodology to be used in addressing these issues.
• Creates detailed analysis of processes and workflows to ensure ongoing improvement in key metrics. Interprets results and preparation of data findings in easily understandable format for varying levels of the organization.
• Responds and communicates timely regarding deliverables.
• Collaborates throughout organization to maximize efficiency and effectiveness.
• Creates user acceptance test scripts/test plans.
• Assists in efforts to provide training, communication, presentations, and project documentation/artifacts.

Responsibilities

Other Job Requirements

Bachelor s degree required.

5+ years of experience in the healthcare industry environment.

5+ years of experience in process improvement, quality management, or data analytics. role in a Managed Care or other healthcare company environment.

May consider 9+ years' experience in lieu of bachelor's degree.

Excellent Analytical, Planning, Verbal And Written Communications Skills Required.

Ability to build analyses and reports and display persuasive data visualization, oral and written communication skills that can translate complex analytic findings and concepts to a varied audience of users.

Requires analytical skills to identify important trends, the ability to use technology tools to explore those trends and the judgment to call on internal experts as required.

Ability to exercise good judgment and manage change effectively.

Ability to consistently meet deadlines and interact with all levels of management and to work collaboratively across departments.

An understanding of CPT, ICD-10, revenue, place of service, diagnosis and billing codes is a plus.

Excellent PC skills required, especially Excel. Proficient in Excel, Access, Outlook, Word, and Visio applications.

SQL Experience with and aptitude for utilizing a data warehouse to obtain and summarize information is a plus.

Strong knowledge of the healthcare delivery system and the key attributes of claims, authorizations, customer surveys, quality measurements, and process improvement methodologies.

Self-starter.

Minimum supervision needed.

General Job Information

Title

Senior Business Operations Analyst - Medi-Cal Rx

Grade

25

Work Experience - Required

Healthcare, Operations, Quality

Education - Required

Work Experience - Preferred

A Combination of Education and Work Experience May Be Considered., Bachelors

Education - Preferred

Masters

License And Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$64,285

Salary Maximum:

$102,855

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.