Business Analyst

Title: Business Analyst

Location: Remote

Company Background

At APV, we’re more than a technology company — we’re a mission-driven powerhouse transforming organizations through advanced technology and human ingenuity. Our expertise spans AI/ML, data architecture, low-code/no-code development, Agile DevSecOps, and cloud services, delivering scalable and meaningful solutions.

In our Emerging Technology Lab, innovation drives progress. Our teams create intelligent chatbots, AI-powered assistants, robotic process automation (RPA), essay graders, and data analytics platforms. If you’re passionate about solving complex challenges and shaping the future, APV is the place for you.

Since 2007, we’ve partnered with federal and state agencies to deliver IT, training, and consulting solutions that achieve mission-critical outcomes. Built on accountability, integrity, and quality, we go beyond expectations.

With 70 prime contracts and a proven record of client success, APV continues to grow — and we’re looking for exceptional talent to grow with us.

At APV, we Always Provide Value.

Role:

The Business Analyst will support a contract for the Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity (CPI) as part of the Provider Enrollment and Oversight program. This position will support the project leadership, project team, and the customer to define, document, and maintain the required business processes needed for an efficient and compliant Adverse Legal Action (ALA) case review operation.

In executing these job functions, this role is expected to identify and collaborate with the project team to implement operational program improvements to increase efficiency, quality, and overall performance of the activities required to conduct ALA case reviews.

Duties:

The Business Analyst will:

· Collaborate with project leadership and the project team to implement, operationalize, and maintain the project requirements related to enrollment ALA case reviews.

· Interact daily with the internal project team, external partner companies, and CMS, as required to support continuing operations.

· Support the development, maintenance, and revision of ALA case review standard operating procedures, process tools, and job aids to ensure cases are reviewed in full compliance with customer requirements.

· Coordinate and communicate closely with the operations analysts to monitor productivity rates, case review quality and consistency, process efficiency, system availability, and employee skillset mix to maintain continuous operations.

· Lead the implementation of project requirement changes as directed by the customer and/or project leadership by modifying SOPs, process tools, and job aids.

· Support the development, implementation, and maintenance of the Quality Audit Plan, as required and directed by the Quality Assurance Manager.

· Support the development and submission of project deliverables, as assigned.

· Support and provide input on the development of training materials to ensure operational readiness of the project team.

· Participate in and support the project and/or customer meetings, as required.

· Assist the operations staff with any barriers, including identifying and defining needed changes to the case management system, improving process documents, reviewing and revising project documentation, identifying staffing needs, and/or resolving customer-related issues, as required.

· Create and Maintain workload, inventory reports

· Other duties, as assigned.

Education:

· Bachelor’s Degree in information technology, Information Systems, Business, healthcare management, or related field. Five years of additional related experience may be used in lieu of a bachelor’s degree.

Required Experience and Skills:

· 5 years of experience writing and editing healthcare-related documents.

· Minimum 5 years of experience working in a healthcare services operation.

· Experience working within the CMS environment is preferred.

· Experience working in a provider enrollment environment is preferred.

· Continuous Process Improvement, Six Sigma, or related training is a plus.

· MS Office-Expert Level knowledge of Excel and other reporting systems

· Experience with electronic workflow systems is a plus.

· Experience with CMS systems is a plus.

· Ability to assess and improve operational processes and workflows.

· Ability to interpret customer requirements and efficiently operationalize them.

· Ability to document business requirements, and create operational process documents, and job aids.

About APV

APV is an Equal Employment Opportunity employer. All qualified applicants are considered without regard to race, national origin, gender, age, religion, disability, sexual orientation, veteran status, or marital status. Minorities/Females/Veterans/Disability candidates are encouraged to apply. Qualified military veterans are encouraged to apply.