Analyst

• support the Quality Management Program through multiple clinical, service and operational activities
• driving continuous quality improvement in patient safety and improvements in efficiency and effectiveness
• supporting activities to measure clinical programs and service processes and outcomes
• reviews, investigates and monitors assigned clinical and quality activities
• follow up with internal medical executives/directors, external health care professionals/facilities, and individual customers
• presentation to the Peer Review Committees
• implement partnerships and participate in initiatives focusing on reducing health disparities
• collect and analyze data, develop studies and reports to workgroups and support quality committee activities
• review clinical metrics and data and monitor for patient safety
• support provider performance measurement activities
• define and document policies, standard operating procedures, workflows and processes
• participate and lead special workgroups and process improvement teams as needed
• support regulatory compliance activities as needed

Lead Analyst, Nurse Quality Clinical Management

• Responsible for technical support, first-line problem/outage analysis, triage, and resolution in a 24x7 Operations Center
• Responding to phone and self-service requests for assistance from users needing technical support
• Provide exemplary customer service and professionalism in efforts to resolve incidents
• Actively participate with other members of the Information Management team in Incident Management
• Provide coordination and support for the management of incoming trouble tickets and their subsequent follow up and closure
• Identify patterns in incidents as well as determine and/or create documentation necessary to efficiently resolve any recurrence of the problem
• Maintain awareness of change management schedules for potential service disruptions
• Meet department-specific performance metrics while adhering to the incident handling policies and procedures

Service Desk Analyst II

• Lead the PACE team and support daily management operations of the sleep therapy queue
• Review work in progress to ensure timely completion and alignment with team priorities
• Monitor team workload and ensure adequate queue coverage to maintain service levels
• Provide coaching, guidance, and day-to-day support to team members
• Manage escalations by identifying issues, coordinating resolution, and communicating updates
• Assist with data analysis to identify workflow trends, gaps, and opportunities for operational improvement

Nurse Case Management Lead Analyst

• Design, develop, and maintain operational reports and dashboards using Tableau and Power BI
• Write and optimize SQL queries to extract, transform, and analyze data from various sources
• Ensure data integrity through validation, cleansing, and documentation
• Collaborate with stakeholders to gather requirements and deliver insights aligned with business goals
• Lead analytics projects or components of larger initiatives, ensuring timely delivery and quality outcomes
• Continuously improve reporting processes and identify opportunities for automation and efficiency

Senior Business Analytics Analyst

• Provide management with expert advice and counsel on business issues using in-depth analysis
• Define user requirements and educate customers on application functionality
• Collaborate with internal and external teams to design and implement business solutions
• Foster positive relationships with key stakeholders to maximize collaboration
• Analyze and synthesize data to evaluate multiple approaches to issues
• Plan and coordinate downtime and upgrades, perform vendor management

Senior IS Applications Analyst, Grand Central, Prelude

• Demonstrate full use and application of standard principles, theories, and concepts related to technical discipline.
• Provide solutions to a variety of moderately complex problems.
• Manage small and moderately complex projects.
• Establish and implement new or revised system requirements or procedures.
• Analyze user requirements.
• Develop and implement systems for moderately complex processes.

IS Applications Analyst

• Manage small and moderately complex projects
• Establish and implement new or revised system requirements or procedures
• Analyze user requirements
• Develop and implement systems for moderately complex processes

Applications Analyst

• Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes
• Collaborate with internal and external clients to understand, and evaluate processes, procedures, job aids and identify solutions for procedural gaps
• Analyze business and user requirements to design solutions and system configurations, specifications, create test plans/use cases perform SI testing, end to end testing and continuously improve adjudication automation and accuracy
• Partner with technology and analytics teams to develop new data sources for reporting and act as liaison between business and technology to execute project initiatives, and resolve issues
• Provide support with production issues as needed

Senior Claims Systems Analyst

• Responsible for account receivable activity for a specific Provider Book of Business tied to account management team
• Key partner to Provider Relations Executives (PRE) and Managers (PRM) supporting strategic planning to improve provider experience
• Ensure timely and accurate claims administration, proactively monitor results, and leverage resources and tools to assist Health Care Providers in managing their accounts receivables
• Provide direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs
• Regularly meet with assigned Health Care Providers to discuss results, review issue trends, and develop action plans for improvement
• Engage matrix partners to achieve service improvements and minimize contract interpretation issues
• Communicate and educate internally regarding issues/trends to minimize errors and improve claim accuracy
• Monitor contractual performance guarantees and late payment interest to minimize financial impacts

Provider Services Lead Analyst

• Review current Behavioral strategies
• Develop formal behavioral support plans
• Conduct staff training and oversight
• Perform periodic reviews for efficacy

Board Certified Behavior Analyst, Virtual or In-person

• Research, interpret, and apply coding, payer, and regulatory requirements to support accurate and compliant Professional and Hospital coding practices
• Develop, maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency
• Coordinate and support coding quality audits by routing requests, maintaining records, and verifying documentation completeness and accuracy
• Analyze coding quality data and audit results to identify trends, risks, and opportunities for improvement
• Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy

Integrity Analyst – Facility Coding Quality, Inpatient

• Handling patient access queries using Epic software
• Managing referrals and scheduling
• Collaborating with healthcare team to improve access process

Patient Access Analyst

• Provide technical development services throughout the System Development Life-cycle (SDLC)
• Lead requirements gathering, design specification, code development, unit, integration, and acceptance testing and implementation support

Principal IS Applications Analyst

• Provide hands-on clinical support under BCBA supervision
• Assist RBTs with program implementation
• Conduct probes and program updates
• Participate in parent training
• Collaborate with school staff on goals

BCaBA – Board Certified Assistant Behavior Analyst, Full Time

• Support RBTs with implementation of BCBA-developed programs
• Assist with RBT onboarding and training
• Conduct probes and update programs under BCBA direction
• Review session data for BCBA

BCaBA, Part Time

• Demonstrate full use and application of standard principles, theories, and concepts related to technical discipline
• Manage more complex projects, establish and implement new or revised system requirements or procedures
• Analyze user requirements, develop and implement systems for moderately complex processes
• Lead activities of project team, mentor and assist others in support of applications, projects and goals
• Initiate, coordinate or lead course correction to stay on schedule while providing professional support for a large multi-facility healthcare organization.

Senior IS Applications Analyst

• Assist in developing and administering a regulatory compliant capital planning and stress testing program for the Credit Union.
• Become familiar with the NCUA’s capital planning requirements and supervisory expectations and stay abreast of emerging changes to expectations.
• Collaborate with internal and third-party providers as part of the capital planning process.
• Responsible for reporting or analysis activities that pertain to understanding the impact of financial performance, strategic initiatives, concentrations and other relevant risk exposures on the enterprise’s overall capital position and risk framework.
• Responsible for aggregating stressed results and investigating their impact on the enterprise capital and balance sheet over time.
• Assist in the development of written procedures, policies and other internal controls that support the capital planning and stress testing process.
• Coordinate with senior leaders in carrying out governance processes related to capital planning.
• Focus on implementing efficient and repeatable processes that are consistent with regulatory expectations and business needs.

Capital Planning Analyst I, II, Senior

• Supports the development and maintenance of Medicaid Fee-for-Service pharmacy pricing and modeling aligned with the company’s mission, strategies, products, and services.
• Oversee core analytical work related to SOW requirements, including, Medicaid MAC pricing analysis, and 340B program impacts and compliance considerations.
• Develop, maintain, and enhance cost analysis and predictive trending models to support Medicaid FFS programs, segmented by SOW, pricing methodology, or program initiative.
• Lead and manage the capture, ingestion, and maintenance of external pricing files (e.g., NADAC, state MAC files, other benchmarks), including, performing data quality checks and validation, identifying and correcting anomalies or errors, conducting timely market research to support pricing accuracy and responsiveness, and resolve or escalate discrepancies, variance, or other anomalies.
• Create and maintain a formal Tier 2 inquiry process for MAC-related issues, including tracking inquiry volume, documenting resolution and outcomes, assessing financial and operational impact, and supporting trend analysis and escalation.
• Collaborate with other leaders to interpret and apply Medicaid regulations, state-specific requirements, and program initiatives to analytical models, pricing strategies, and reporting outputs.
• Collaborate with internal stakeholders (e.g., Client Services, Contracting, Operations, Compliance) to evaluate the financial and contractual impact of Medicaid pricing and program decisions.
• Interact with external stakeholders and vendors, building collaborative relationships to support pricing accuracy, data transparency, and program execution.
• Support leadership with ad hoc analysis, forecasting, and scenario modeling related to Medicaid FFS pricing, program changes, and regulatory developments.
• Assist leadership in supporting new Medicaid program initiatives, enhancements to pricing methodologies, and expansion of analytical capabilities.
• Contribute to the development of client- or state-facing materials and presentations, as needed, to explain pricing methodology, cost drivers, and program impacts.
• Periodic and detailed reporting of activities and opportunities to leadership.
• Other duties as assigned.

Senior Analyst, Government Pricing

• Maintain and administer Medicaid fee for service drug pricing methodologies in accordance with federal and state Medicaid requirements.
• Monitor and incorporate National Average Drug Acquisition Cost (NADAC) updates and related CMS guidance into pricing models and operational systems.
• Evaluate and apply HRSA 340B ceiling price considerations and exclusions as applicable to Medicaid reimbursement models.
• Ensure pricing methodologies align with state specific Medicaid reimbursement rules and contractual requirements.
• Accountable to cross-walk FDB to Medispan or visa versa to ensure compliance with State Medicaid Prescription Drug List and ensure ongoing reconciliation and updates.
• Support compliance with federal and state audit, reporting, and transparency expectations related to Medicaid drug pricing.
• Maintain and manage industry pricing and reference sources, including but not limited to Medi Span multisource and product codes (e.g., MONY indicators), NADAC pricing files, and HRSA 340B ceiling price date.
• Validate integrity, completeness, and timeliness of reference data used in pricing and modeling and resolve or escalate discrepancies.
• Assess industry changes that may impact Medicaid pricing assumptions or reimbursement outcomes.
• Maintain, and update financial models supporting Statements of Work (SOWs) for Medicaid fee for service pricing arrangements.
• Perform detailed pricing impact analyses to support SOW development, amendments, and renewals.
• Manipulate and analyze large data sets specific to SOW requirements, pricing guarantees, and reimbursement terms.
• Partner with internal stakeholders to ensure SOW pricing assumptions are accurate, documented, and supportable.
• Other duties as assigned.

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