Operations Analyst

Job Summary

A company is looking for an Operations Analyst.

Key Responsibilities

• Oversee claims benefit interpretation and system configuration for State and CMS
• Gather business requirements for claims benefit configuration and support system updates
• Ensure compliance with state and CMS requirements, including audit performance and encounter data reporting

Required Qualifications, Training, and Education

• Bachelor's degree in healthcare or related field, or equivalent experience
• Minimum three years of managed care/health plan operations experience
• Minimum two years of business/operations analysis experience
• Preferred background in Medicaid and Medicare claims adjudication and benefits configuration
• Experience in managed care operations and business analysis in a related field