Sr. Business Analyst- Remote

Sentara Healthcare

Richmond Virginia

United States

Consulting & Corporate Strategy
(No Timezone Provided)

Sentara Health Plans is currently hiring aSr Business Analystfor Virginia Premier!This is a Full Time position with day shift hours and great benefits!Position is located in Glen Allen, VA.Job Requirements:Education: Bachelor's Level Degree; Master's degree preferredRequired: Analytics - 3 years, Healthcare - 3 years, Strong SQL and EXCEL experience, Project Management - 3 yearsPreferred skills: Tableau, problem solving, MS Office Suite (Strong in excel)Preferred: Prior experience with encounter data submissionPreferred: Prior experience with CMS-HCC modelsPreferred: Six Sigma Green BeltJob Responsibilities:Responsible for developing and extensive expertise in the data and systems leveraged by the Revenue Management teamDevelop expertise in CMS Medicare, HHS Exchange, and Medicaid data and risk adjustment including: risk score calculation and financial risk receivable calculationsDevelop expertise in, Risk Adjustment Processing System (RAPS), Encounter Data Processing System (EDPS), and EDGE submission and reconciliation processesParticipate in report development and automation using Microsoft SQL Server (SSRS, SSIS), Tableau and other analytical software products and toolsDevelop repeatable and ad-hoc reports related to multiple product lines and business units as assignedDocument applications for use in training, maintenance, and department proceduresAssist in the training, developing, and growth of new analysts, as well as act as project lead on requested analysesPerform complex queries. Apply extensive understanding of database tables, relations, data types and valuesAssist in development of benchmark reportsAssist in the analysis and presentation of business opportunitiesSentara Health Plans is the health insurance division of Sentara Healthcare doing business as Optima Health and Virginia Premier. Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health. This position is responsible for the implementation and support of quality initiatives within assigned areas. Provides subject matter expertise related to quality initiative implementation, reporting and analysis. Is a liaison between internal/external customers and Information Technology for business definition, scope, testing and implementation to ensure quality, efficiency, effectiveness, and customer knowledge to improve business practices.Education LevelBachelor's Level DegreeExperienceRequired: Analytics - 3 years, Healthcare - 3 years, Project Management - 3 yearsPreferred: None, unless noted in the "Other" section belowLicenseNone, unless noted in the "Other" section belowSkillsRequired: Communication, Complex Problem Solving, Microsoft Access, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Quality Control Analysis, Service Orientation, Technology/ComputerPreferred: None, unless noted in the "Other" section belowOtherMaster's degree preferred.

Sr. Business Analyst- Remote

Sentara Healthcare

Richmond Virginia

United States

Consulting & Corporate Strategy

(No Timezone Provided)

Sentara Health Plans is currently hiring aSr Business Analystfor Virginia Premier!This is a Full Time position with day shift hours and great benefits!Position is located in Glen Allen, VA.Job Requirements:Education: Bachelor's Level Degree; Master's degree preferredRequired: Analytics - 3 years, Healthcare - 3 years, Strong SQL and EXCEL experience, Project Management - 3 yearsPreferred skills: Tableau, problem solving, MS Office Suite (Strong in excel)Preferred: Prior experience with encounter data submissionPreferred: Prior experience with CMS-HCC modelsPreferred: Six Sigma Green BeltJob Responsibilities:Responsible for developing and extensive expertise in the data and systems leveraged by the Revenue Management teamDevelop expertise in CMS Medicare, HHS Exchange, and Medicaid data and risk adjustment including: risk score calculation and financial risk receivable calculationsDevelop expertise in, Risk Adjustment Processing System (RAPS), Encounter Data Processing System (EDPS), and EDGE submission and reconciliation processesParticipate in report development and automation using Microsoft SQL Server (SSRS, SSIS), Tableau and other analytical software products and toolsDevelop repeatable and ad-hoc reports related to multiple product lines and business units as assignedDocument applications for use in training, maintenance, and department proceduresAssist in the training, developing, and growth of new analysts, as well as act as project lead on requested analysesPerform complex queries. Apply extensive understanding of database tables, relations, data types and valuesAssist in development of benchmark reportsAssist in the analysis and presentation of business opportunitiesSentara Health Plans is the health insurance division of Sentara Healthcare doing business as Optima Health and Virginia Premier. Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health. This position is responsible for the implementation and support of quality initiatives within assigned areas. Provides subject matter expertise related to quality initiative implementation, reporting and analysis. Is a liaison between internal/external customers and Information Technology for business definition, scope, testing and implementation to ensure quality, efficiency, effectiveness, and customer knowledge to improve business practices.Education LevelBachelor's Level DegreeExperienceRequired: Analytics - 3 years, Healthcare - 3 years, Project Management - 3 yearsPreferred: None, unless noted in the "Other" section belowLicenseNone, unless noted in the "Other" section belowSkillsRequired: Communication, Complex Problem Solving, Microsoft Access, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Quality Control Analysis, Service Orientation, Technology/ComputerPreferred: None, unless noted in the "Other" section belowOtherMaster's degree preferred.