Senior Business Analysis Professional

Job Summary

A company is looking for a Senior Business Analysis Professional - Operations.

Key Responsibilities

• Lead DSNP Compliance for DMR by developing and implementing strategies to meet regulatory requirements
• Oversee the full lifecycle of DSNP program implementation, ensuring timely project completion
• Act as Change Team Lead for DMR processes, facilitating smooth transitions to new systems and workflows

Required Qualifications

• At least 5 years of experience in analyzing data, improving business processes, and DMR Claims Processing
• At least 3 years of experience with claims or prior authorization management systems
• Familiarity with CMS Prescription Drug Manuals and federal/state requirements for DMR Claims Processing
• Strong analytical skills focused on root cause analysis and effective solution development
• Proficiency in Microsoft Office applications