Analyst

• Perform monthly close processes and variance analysis
• Educate and coach client services on accounting concepts
• Create Standard Operating Procedures, ensuring processes are followed; identify best practice across portfolio
• Support Client Services in preparing and reviewing Master Data Forms for key clients, ensuring accuracy and compliance
• Support Client Services and Finance Managers in developing and managing annual budgets and monthly forecasts
• Prepare financial reports, dashboards, and quarterly business review decks
• Collaborate with operations to identify financial risks and opportunities
• Ensure compliance with accounting standards and internal controls
• Coordinate with legal and finance teams on contract and billing matters
• Interface with internal teams and clients to align on expectations and deliverables
• Generate reports to track performance metrics and support decision-making
• Provide administrative support to regional managers, planners, and schedulers
• Maintain a high level of professionalism in all communications

Senior 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 development and implementation of member materials for Medicare Part D members
• managing, proofing, and revising materials while ensuring quality, accuracy, and timely delivery to production partners
• proofreading and editing both CMS required and custom documents
• collaborating with teammates & partners with other functional business areas to ensure all workflow processes are completed and remain on track
• collaboratively works with internal partners to obtain agreement from all impacted parties
• collaboratively drive process improvements and enhancements and implement new ideas that supports and improves the team
• independently identify and problem solve issues that negatively impact projects and documents

Senior Member Materials Analyst

• 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

• Review and research suspended claims per DVHA guidelines.
• Refer claims to the appropriate department for further review when necessary.
• Process claim adjustments and corrections as needed.
• Prepare and issue Return to Provider (RTP) notices for incomplete or incorrect claims.
• Maintain and update claims resolution procedure documentation.
• Train backup or replacement staff as needed.
• Perform other duties as assigned.

Claims Resolution 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

• Coordinate with citizen developers to ensure adherence to automation standards
• Lead technical upskilling initiatives and provide mentorship
• Design robust solutions in collaboration with teams
• Oversee the lifecycle of citizen projects and validate outputs
• Conduct rigorous software testing and manage technology administration

Lead Analyst, Technology & Automation

• Participates in the design, implementation, and administration of compensation programs
• Provides expert, data-driven guidance to core and field-based HR partners and leaders
• Evaluates roles and analyzes market data to support pay decisions
• Conducts market pricing and salary benchmarking
• Analyzes compensation and workforce data
• Administers annual compensation cycles and maintains compensation databases

Compensation Analyst

• Perform a variety of duties assisting the Quality Manager & Chief Inspector in administration and compliance of the Quality Management System (QMS) per PWES, ISO 9002 and AS9110 requirements.
• Lead/coach teams through use of CORE, RCCA, QAT, and other Process Improvement tools.
• Assist site Chief Inspectors in conducting ROM (Risk and Opportunity Management), SRAs/SRMs Assessments.
• Conduct QMS compliance audits of processes, procedures, records.
• Recommend corrective actions and process improvements in response to audit findings.
• Analyze and maintain KPI metrics that impact Quality and develop recommendations for improving compliance with internal standards.
• Review, analyze, and determine root cause for reported non-conformities.
• Investigate and recommend preventive actions to resolve problems regarding non-conformities.
• Prepares and maintains Quality systems (documentation, processes and training).
• Monitor spoiled work database collection system, sort and prioritize data to target areas for investigations.
• Conduct Process Audits and assessments; review processes identified by QA as ineffective or incorrect.

Quality Analyst – Onsite

• 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

• Assist key stakeholders, such as customers, third-party vendors, and Mark43 engineering teams, through the different stages of technical implementation, including requirements gathering, solutioning, documentation, mapping, configuration, and user acceptance testing.
• Track technical project schedules with stakeholders, help identify schedule risks, and support Implementation Managers with mitigation strategies.
• Configure, schedule, and maintain containerized software across a multi-cloud environment.
• Update external-facing technical documentation to educate stakeholders on Mark43 technical solutions.
• Work towards a worthwhile mission with a team of friendly and intelligent coworkers.

Integrations Analyst

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

Patient Access Analyst

• Provide end-user support, analyzes and diagnoses system problems, identifies root cause, and then solves the problem or escalates issues to other appropriate IT staff when outside area of responsibility or expertise.
• Partners with vendor to troubleshoot and resolve system problems, to improve product performance and usability.
• Provides vendor with recommendations for system improvements.
• Addresses technical issues that occur during installation and maintenance activities.
• Designs, implements, and supports applications while ensuring ongoing optimization and performance.
• Translates technical requirements into development specifications and provides product management support.
• Evaluates and documents system updates, upgrades, and their impacts in collaboration with analysts and end users.
• Participates in system implementations, upgrades, and continuous improvement initiatives.
• Conduct system testing, validation, and quality assurance to ensure compliance and optimal system performance.
• Develop and maintain documentation, including build specifications, test scripts, and training materials, including the delivery of training when necessary.
• Partner with clinical staff and IT professionals to evaluate, design, develop, test, implement, and maintain systems.
• Partner with clinical staff and IT teams, to ensure workstations, printers, scanners, mobile devices, and other peripherals are aligned with the functional and compatibility requirements of Epic applications.
• Strategically lead and collaborate on cross-functional application initiatives with application and operational teams to ensure seamless integration, streamlined workflows, and optimal system performance.
• Maintain vendor certifications required to support the analyst's application areas of responsibility.
• Support system integrations and interoperability efforts with other third-party applications and interfaces.
• Assisting as needed with after hour activities such as go lives, upgrades, downtimes, and other special project.

Senior Epic 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

• Responsible for processing conflict searches for daily new client and new matter requests in a timely manner.
• Perform detailed corporate research using various search resources.
• Includes analysis, interpretation, and application of information via recent press releases and historical references to entities.
• Thorough review of Intapp Open workflow requests including detailed understanding of the submissions to ensure key information is included for appropriate processing.
• Provide detailed review of Conflict Results Report to identify true potential conflicts based on established team guidelines.
• When appropriate, conduct necessary research to determine materiality of potential conflicts.
• Research Conflicts Database and other firm documents to ensure appropriate conflicts resolution.
• Contact the appropriate request stakeholders in effort to clear potential conflicts.
• Communicate daily with the Manager regarding resolution of potential conflicts of interest or any areas of concern relevant to pending requests.
• Thoroughly document and organize documentation regarding the resolution of potential conflicts of interest.
• Maintain telephone and personal contact with attorneys and staff on conflict of interest matters.
• Track status of outstanding or on-going Work Flow requests.
• Handle special projects assigned by the Director of Conflicts Operations and Conflicts Managers.

Conflicts Analyst

• Collaborating with individual departments to ensure charges are captured, entered, documented and reconciled timely and accurately.
• Working with departments to develop processes to eliminate billing edits related to the revenue integrity functions.
• Staying current on government regulatory changes and Federal and State proposals to change charging and reimbursement methodologies and payment systems.
• Developing, implementing and providing ongoing monitoring and education related to revenue integrity throughout the Revenue Cycle process.
• Developing processes which are designed to optimize and support revenue integrity, reduce risk and eliminate waste.

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