Analyst

• Leads system requirements analysis and validation activities using established industry methodologies, ensuring requirements are complete, consistent, traceable, feasible, and conform to standards.
• Builds and maintains deep knowledge of the business processes, capabilities, and services supported by the platform and applies that expertise to guide requirements definition, solution design and prioritization, collaborating with product stakeholders and revenue partners.
• Establishes, documents, implements, and continuously improves processes for system planning, requirements definition, and release planning.
• Partners with customers, project managers, and revenue stakeholders to understand needs and present solutions that align with business and technical objectives.
• Defines system and solution approaches based on experience, sound judgment, and creative problem solving.
• Provides system development effort and cost estimates in support of ROI analysis and resource planning.
• Produces and maintains initiative system documentation and platform system documentation.
• Works with engineering teams to develop user stories, use cases, and delivery plans.
• Creates and maintains technical documentation for use by engineering and operations teams.
• Continuously expands understanding of business processes, platform capabilities, and supported services to improve solution quality, decision-making and stakeholder outcomes.
• Troubleshoots and resolves issues in existing systems to improve reliability and performance.
• Provides work breakdowns, schedules, and coordination for assigned initiatives.
• Other duties as assigned.

Platform Analyst – Advisor

• Leads system requirements analysis and validation activities using established industry methodologies, ensuring requirements are complete, consistent, traceable, feasible, and conform to standards.
• Builds and maintains deep knowledge of the business processes, capabilities, and services supported by the platform and applies that expertise to guide requirements definition, solution design and prioritization, collaborating with product stakeholders and revenue partners
• Establishes, documents, implements, and continuously improves processes for system planning, requirements definition, and release planning.
• Partners with customers, project managers, and revenue stakeholders to understand needs and present solutions that align with business and technical objectives.
• Defines system and solution approaches based on experience, sound judgment, and creative problem solving.
• Provides system development effort and cost estimates in support of ROI analysis and resource planning.
• Produces and maintains initiative system documentation and platform system documentation.
• Works with engineering teams to develop user stories, use cases, and delivery plans.
• Creates and maintains technical documentation for use by engineering and operations teams.
• Continuously expands understanding of business processes, platform capabilities, and supported services to improve solution quality, decision-making and stakeholder outcomes.
• Troubleshoots and resolves issues in existing systems to improve reliability and performance.
• Provides work breakdowns, schedules, and coordination for assigned initiatives.
• Other duties as assigned.

Platform Analyst – Advisor/Manager

Senior Platform Analyst

• Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance.
• Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams.
• Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes.
• Mentor and train Coding Specialists, and provide policy-related training and support to operational partners such as customer and provider services.

Health Services Coding Analyst, CPC Required

• Conduct thorough research and investigation of participant accounts to identify potential fraud or suspicious activity
• Analyze large datasets and spreadsheets, including reviewing IP addresses, transaction histories, and account behaviors, to detect patterns or irregularities
• Identify and escalate findings where information appears inconsistent, out of place, or indicative of fraudulent behavior
• Prepare and issue legal notices and correspondence to clients and participants related to fraud investigations
• Maintain strict confidentiality when handling sensitive personal and financial information
• Perform daily report reviews to monitor system-generated alerts, flagged accounts and ongoing account activity
• Ensure all investigations and documentation are completed accurately and in compliance with internal policies and regulations
• Meet strict deadlines for case resolution, reporting, and compliance requirements
• Maintain detailed, organized documentation of case findings and actions taken
• Collaborate cross-functionally with compliance, legal, service, and operations, and executive leaders as needed
• Continuously monitor trends and patterns to proactively identify emerging fraud risks
• Assist teammates with escalations, appeals, Salesforce cases and tasks as needed
• Other duties as assigned

Fraud Analyst

• Work closely with relevant departments to secure customer data and financial statements
• Perform credit analysis for new and existing customers and assess the credit risk associated with the proposed or assigned credit line
• Perform in-depth financial analysis and provide recommendations to support management decision-making
• Create ad-hoc analyses, executive summaries, and recurring reporting to support management decision-making
• Monitor and analyze key economic indicators across AMER, EMEA, and APAC
• Identify potential risks and opportunities within the Global customer portfolio
• Perform cash flow analysis and create customer forecasts
• Conduct research and conceptualize new techniques, ideas, and solutions for a variety of credit challenges
• Provide relevant departments with critical updates on the financial condition of their customers
• Partner with Sales and Sales Operations to support order management decisions by monitoring credit exposure, past-due trends, and dispute risk
• Work as one global team: coordinate and facilitate credit and collections efforts with close communication and collaboration across regions
• Enforce credit policies and procedures

Analyst II – Credit

• 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

• Lead role responsible for all aspects of the software development lifecycle for both package and custom developed applications
• Works independently with limited supervision to design, develop, test, deploy and maintain software solutions
• Manage large projects and processes through the entire system development lifecycle
• Provide time and cost estimates for proposed changes resulting from the requirements
• Coordinate and communicate development activities with other team members, infrastructure personnel, vendors and management

IT Gas Measurement Application Analyst IV

• 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

• Support intake and tracking of business control changes
• Maintain visibility into change status, approvals, and timelines
• Follow up with stakeholders to ensure timely progression through required steps
• Review submitted documentation for completeness and adherence to defined standards
• Ensure required artifacts are present prior to stakeholder review, including:
• Intake forms
• Impact summaries
• Supporting documentation
• Return incomplete or unclear submissions to business owners for revision
• Confirm that impacted teams have updated procedures prior to implementation
• Validate that documentation reflects the intended change at a high level
• Escalate gaps where procedures are missing, outdated, or inconsistent
• Coordinate required reviews across relevant teams such as Compliance, IT, and Operations
• Track approvals and ensure all required stakeholders are included
• Document approval status and maintain records
• Enforce “no implementation without required approvals” standards
• Identify and escalate instances of non adherence to control processes
• Support consistent use of defined templates and workflows
• Maintain organized and complete records of all control related activities
• Ensure documentation is audit ready and centrally accessible
• Track issues identified during the change process
• Follow up on open items and escalate when needed
• Support remediation tracking to closure
• Can require completion of documentation before progressing changes
• Can flag and escalate missing approvals or control gaps
• Cannot approve business decisions, strategy, or procedural content
• Works within an established controls framework
• Focuses on execution and coordination
• No direct people management responsibilities
• Partners with business and functional teams to support compliant change execution

Business Controls Analyst

• Oversees the functional support of all human resources systems to ensure the human resources organizational system needs are met.
• Supports both the systems and the processes of HR business unit, acting in a liaison role between human resources and information technology.
• Identifies opportunities to streamline business processes to best leverage human resources systems and then translates functional requirements for a business process or application into technical changes within human resources systems.
• Develops and maintains testing plans and scenarios to ensure that all modules and functionality are fully tested including application and unit test, integrated test, parallel test, performance and stress test.
• Completes system testing per the testing plans and helps information technology resolve any defects.
• Maintains policy and procedures documentation in support of business processes and end user training.
• Develops and delivers Human Resources system training and end user support.

HRIS 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

• Complete EDD reviews for assigned periodic and event driven alerts within a designated timeframe in accordance with established procedures
• Conduct open-source data searches using multiple resources to gather and analyze necessary information about the customer, business partners, owners, controllers, and other connected parties as appropriate
• Analyze transactional data within a given timeframe and identify any potential red flags or inconsistencies
• Organize and synthesize information compiled into a clear evaluation and recommended actions
• Prepare detailed and succinct customer narratives that can be clearly understood by an independent tester, auditor, or regulator
• Escalate identified financial crimes red flags and unusual activity using sound judgement
• Provide support for ad-hoc projects as assigned

EDD Analyst II

• Power BI Report Development: Development of HR reports and dashboards primarily in Power BI using data from ADP Workforce now and other HRIS platforms, Automation of reports, using Power Automate Workflows and other automation tools Ensure reports are accurate and delivered to stakeholders in a timely manner.
• HR Data Analysis: Assist in analyzing HR data to identify trends and provide insights on key metrics such as turnover, employee engagement, and workforce demographics. Support the creation of Department Level KPI’s. Review reports daily for any data integrity Issues, and alert appropriate departments managers to input data. Maintain and update the Audit Schedule, to make sure all data is being checked on an ongoing basis. Perform data validation and integrity checks to ensure accurate reporting.
• Data Governance and Quality: Support the enforcement of data governance policies by conducting data audits and validation checks. Assist in maintaining the accuracy and consistency of HR data across various platforms.
• Stakeholder Collaboration: Work closely with the HRIS Analytics Manager and other HR teams to gather reporting requirements. Provide ad-hoc reports and data as needed to support business initiatives, including frequent AD Hoc ADP custom Reports.
• Training and Support: Provide basic support to HR and business users on how to access and interpret Power BI reports. Assist in the development of training materials to help users leverage HR data more effectively.
• Continuous Improvement: Participate in process improvement initiatives aimed at enhancing the efficiency of HR reporting and data analysis. Stay updated on new Power BI features and best practices to improve reporting capabilities.
• Work Style and Mindset Self-driven and resourceful, able to take ownership of projects, troubleshoot independently, and deliver results with minimal oversight while collaborating effectively across teams.

Senior HRIS Analyst – Power Automate

• Prepare and provide analysis of the Avera Health Medicare, Medicaid and Tricare hospital, RHC and nursing home annual cost reports and audits.
• Assists with the Medicare and Medicaid audits for the Avera Health.
• Assemble Medicare and Medicaid 3rd Party Settlement Reserves analysis for all Avera Health PPS and CAH Hospitals, RHCs and nursing homes.
• Assists with the monthly contractual reserve calculation for all Avera Health Hospitals, clinics, and nursing homes within RCA.

Reimbursement Analyst

• 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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Platform Analyst – Advisor

Platform Analyst – Advisor/Manager

Senior Platform Analyst

Senior Platform Analyst

Health Services Coding Analyst, CPC Required

Fraud Analyst

Analyst II – Credit

Board Certified Behavior Analyst, Virtual or In-person

IT Gas Measurement Application Analyst IV

Integrity Analyst – Facility Coding Quality, Inpatient

Patient Access Analyst

Business Controls Analyst

HRIS Analyst

BCaBA – Board Certified Assistant Behavior Analyst, Full Time

BCaBA, Part Time

EDD Analyst II

Senior HRIS Analyst – Power Automate

Reimbursement Analyst

Senior Analyst, Government Pricing

Analyst, Government Pricing