Business Analyst
Providence
MS SQL ServerSQL
Business Analyst
Providence
full-time
Posted on:
Origin: • 🇺🇸 United States • Washington
Visit company websiteSalary
💰 $38 - $60 per hour
Job Level
Mid-LevelSenior
Tech Stack
MS SQL ServerSQL
About the role
- Maintain and update the GE/Centricity/IDX Managed Care Application (MCA) module for US Family Health Plan's managed care line of business
- Build fee schedules, provider and vendor dictionary entries, and plan benefits and exclusions
- Assist with health plan utilization management reporting for the organization
- Ensure optimal payment methodology for payments from US Family Health Plan to vendors and other providers
- Responsible for all reports and data transfers to the Department of Defense and its contractors
- Provide support for the quality management program
Requirements
- Bachelor’s Degree in related field or Equivalent experience in Health Care Business Administration as required by URAC.
- Minimum of four years’ experience in managed care operations or large group practice setting.
- Microsoft SQL Server experience
- Must have knowledge of and experience in coding with both CPT and ICD-9 and ICD-10.
- Must possess an understanding of financial/administration/clinical business functions and the interfaces/relationships between applications in healthcare.
- Preferred: Experience with Access and reporting from a warehouse type database.
- Preferred: Experience with HEDIS reporting.
- Preferred: Experience with GE/Centricity/IDX healthcare software application.
- Preferred: Clinic setting operations experience highly desirable.
