Description

The Business Analyst is responsible for designing, generating and analyzing ad hoc reports pertaining to client needs and serves as the point person for providing an overview of these findings to the Client Services Team to share with clients or perspective clients. In addition, this position has a solid understanding of the claims adjudication process and will leverage knowledge and experience pertaining to proprietary Prime Health Services (PHS) technologies when creating analysis and recommended courses of action. This position reports to the Executive VP of Client Services and works collaboratively with Client Services, Sales, Account Management, and other departments as needed/requested.

Essential Job Functions

• Generate / trouble shoot reports i.e. geographic access and others pertaining to overall penetration and savings for large claim samples in a timely manner
• Return disruption reports generated from Prime Testing to the appropriate PHS staff within the three (3) to five (5) business days service level turnaround
• Identify data elements to build queries, join tables to create analytic views, and prepare client reports
• Analyze trends in reports pertaining to multiple product lines
• Track results from initial analysis compared to monthly cycles (3,6,9, and/or 12 ) to identify areas of improvement related to the PHS Network and the overall process
• Summarize results, analyzes data, and presents conclusions to management for review
• Format existing Excel files into formats accepted by PHS’s proprietary software 
• Interpret claims data from various sources and effectively clean and standardize data from different sources into a consistent format to facilitate accurate matching and analysis 
• Conduct a QA review of results prior to submitting to ensure results accurately reflect the PHS network
• Identify areas for process and system improvements
• Identify provider gaps or expansion areas for targeted recruitment for a better marketing position

Requirements

Education and Experience Qualifications

• Bachelor’s Degree in Information Technologies or related field of study from an accredited college or university, or equivalent experience required
• A minimum of 2 years of related experience, preferably in a healthcare related environment, is required
• Experience interfacing with members of the senior leadership team is preferred 

Competencies

• Demonstrated negotiation skills and proficiency using Microsoft Office Suite (Excel, PowerPoint, Word)
• Proficiency in basic SQL commands and queries
• Must be able to successfully work in a remote, collaborative, deadline driven work environment
• Professional, friendly demeanor with excellent written and oral communication skills
• Flexible, adaptable, creative, organized and self-motivated with a strong attention to detail

Physical Requirements

This position requires light work (L). Light work is defined as, exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly. However this position is typically performed in a seated position with no pulling or pushing or use of leg controls.

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