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CareSource
Charlotte, NC, United States
Job Summary: The Health Plan Operations Analyst I reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems and participates in development of solutions to improve or further leverage these functions. Essential Functions: Participates in the development of new market operation initiatives from concept
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Job Source: Kuraray America, Inc.Charlotte, NC, United States
Job Summary:
The Health Plan Operations Analyst I reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems and participates in development of solutions to improve or further leverage these functions.
Essential Functions:
Participates in the development of new market operation initiatives from concept to implementation and provide statistics measuring progress throughout
Market process issues ID card issue resolving wrong co-pay information.
Helping to align the mismatches in our Single Case Agreements where policy does not match market direction and operations is doing something completely different (project facilitation).
Marketplace state competitive analysis.Bringing existing membership numbers, eligibility numbers and local competitive intelligence together to facilitate and make decisions with market president.
Assist Market President, BD and Operations with project management or NC Medicaid contract
Collect and analyze data in support of business case creation and realization
Contribute to ensuring operational effectiveness by assisting in the development of strategic plans for market operations, including business, financial, and operational goals and objectives
Assist in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information
Develop, document and perform testing and validation as needed
Work with peers to achieve cross-functional capability with project execution and subject matter expertise
Participates in the discussions of challenging the standard thinking with new ideas, approaches, and solutions which focus on process improvement and growth
Perform any other job duties as requested
Education and Experience:
Bachelor's degree in Engineering, Business, Finance, Economics or related field or equivalent years of relevant work experience is required
Minimum of one (1) years of analytical experience is preferred
A minimum of three (3) years of health care operations or project management experience is preferred
Competencies, Knowledge and Skills:
Advanced proficiency in Microsoft Office Suite to include Word, Excel, Access and PowerPoint
Familiar with a variety of analysis concepts, practices and procedures
Excellent written and verbal communication, facilitation and presentation skills
Strong interpersonal skills and high level of professionalism
Effective listening and critical thinking skills
Effective problem solving skills with attention to detail
Ability to work independently and within a team
Strong analytical skills
Ability to create and maintain excellent working relationships
Time management skills, ability to develop, prioritize and accomplish goals with a sense of urgency
Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
Ability to multi-task and remain flexible during organizational and/or business changes
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit or stand for long periods of time
May be required to travel occasionally
Compensation Range:
$52,400.00 - $83,900.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
Health Plan Operations Analyst- Ashville NC Area jobs in Charlotte, NC, United States
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