Analyst, Business
RemoteUnited States
Job Summary
Develop and maintain requirement documents for coverage, reimbursement, and processing functions to ensure alignment with regulatory baselines and health plan policies. Coordinate with stakeholders, subject matter experts, and partner organizations to lead development reviews, interpret changes, and manage solution traceability through regular meetings. Conduct root cause analysis to assist with problem management and engage with operations leadership to review compliance-based issues for benefit planning. Build Virtual Instructor-Led Training sessions in the Learning Management System while identifying automation and AI tools to streamline workflows. Support intake triage, scheduling logistics, and report reconciliation activities to ensure timely leadership reporting on requirement impacts.
Required Qualifications
- At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience
- Strong analytical and problem-solving skills
- Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams
- Previous success in a dynamic and autonomous work environment
Desired Qualifications
- Project implementation experience
- Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA)
- Medical Coding certification
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