Data Management Business Systems Analyst Senior

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.


Role Overview


This Business Systems Analyst Senior role primarily supports Medical Economics, Population Health, and/or Risk Adjustment teams through Azure Data Lake capabilities. The role assists with enterprise business semantic layer data set, data ingestion, data analysis, and functional requirements delivery across SDLC and Agile lifecycles. Strong SQL, Oracle, and analytical skills are required. Healthcare insurance experience is required, with experience in Medical Economics or Risk Adjustment analytics preferred.


Work Arrangement


+ This is a hybrid, office based position working in our Ellis Preserve office located in Newtown Square, PA

+ Office days are Tuesday, Wednesday, & Thursday; Remote days and Monday & Friday


Responsibilities


+ Assist in building and maintaining analytical data sets that support Risk Adjustment, Medical Economics, and Population Health reporting and analytics needs

+ Apply core healthcare domain knowledge to translate business needs into data requirements, mappings, and functional documentation for analytical solutions

+ Bring hands-on experience or strong foundational understanding in at least one area: Risk Adjustment, Medical Economics, or Population Health

+ Data file analysis and problem resolution of inbound files

+ Data analysis using Excel, SQL, or other toolsets

+ Document preparation (Functional Requirements – FRD)

+ SDLC and Agile lifecycle adherence and management of change control process and approvals

+ Maintain team documentation of data inventory, mapping document and flow diagrams

+ Assists in managing large scale projects, leads appropriate resources and determines project requirements and deliverables, to ensure successful implementations to meet ACFC user needs

+ Assists in ensuring successful project conclusions and large-scale projects as measured by meeting ACFC Corporate objectives and large-scale projects

+ Responsible for leading, evaluating and providing technical and project life cycle methodology

+ Communicates business or process solutions, recommendations and issues to ACFC management on a regular basis

+ Interacts with ACFC user areas, regularly, to discuss, observe and review tasks associated with their division as measured by successful implementation of project requests

+ In accordance with established regular communications with Manager, keeps staff apprised of progress, problems, and objectives, and initiatives discussions and solicits input regarding business priorities, plans, and progress


Education and Experience


+ At least five (5 ) to seven (7) + years of experience in healthcare industry (Medicaid, Medicare) required and in Risk adjustment or medical economics and analytics preferred

+ Minimum three (3) to five (5) years of direct user interface experience

+ Ability to manage multiple tasks and projects; excellent writing and communication skills

+ Possess detail understanding/ data domain expertise in Claims, enrollment and/ or Population Health in Payer Organizations

+ Strong SQL skills with ability to create and build queries

+ Understanding of ETL technologies from a BSA perspective

+ Bachelor’s degree in Computer Science, Information Systems, or a related field; or equivalent related work experience


Other Skills


+ Strong understanding of Medicaid managed care data

+ Advanced analytical and problem-solving skills to address complex business questions

+ Advanced capabilities in pulling, validating, and synthesizing data to derive actionable insights for the organization

+ Excellent verbal and written communication skills, with the ability to clearly convey insights to technical and non-technical audiences

+ Strong organizational skills and ability to manage multiple priorities in a fast-paced environment


Our Comprehensive Benefits Package


Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.


Your career starts now. We’re looking for the next generation of health care leaders.


At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.


Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.


Discover more about us at www.amerihealthcaritas.com.
As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.