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Business Analyst Senior - Provider Reimbursement

Company: Tufts Health Plan
Location: Canton
Posted on: April 2, 2021

Job Description:

Business Analyst Senior - Provider Reimbursement Canton, MA We enjoy the important work we do every day on behalf of our members.Job SummaryUnder direction of the Manager of Provider Reimbursement, the Business Analyst Senior is responsible for assessment, planning, coordination and implementation of defined projects that support departmental and cross-departmental initiatives, as well as organizational initiatives. The Business Analyst Senior will perform duties, including but not limited to, representing department on projects, project planning and implementation, implementation task identification, facilitation of meetings, identification and managing risk, facilitating department communications, and system testing for pricing system changes to support initiative(s). The Business Analyst Senior must have the ability to clearly articulate work status, issues and concerns develop recommendations, and present proposals. The Business Analyst Senior works with other professionals throughout the organization to support current business needs and priorities.Job Description

  • Provide project support as a Provider Reimbursement project participant or Provider Reimbursement area project lead for large-scale organizational projects by providing the operational perspective and/or leading an operations/functional area subgroup. Provide data and analytic support of these projects post go live to ensure proper monitoring of implementation.Project Type Examples:
    • Corporate Agenda Projects
    • Interdepartmental Cross Functional Initiatives
    • New product development
      • Assist IT and partner departments with writing business requirements and complete system testing for any logic/functionality changes needed to resolve problems or enhance/alter current functionality.
        • For departmental projects, lead project or initiative, consult with Provider Reimbursement Management Team, and develop project plan, time frames, communication plans, milestones and deliverables. Lead workgroups, facilitate discussions and conduct research and system and/or data analysis on issues as needed for departmental initiatives which may involve cross functional work with other departments.Project Examples:
          • Departmental process improvement initiatives
          • Regulatory implementations
            • Monitor projects and initiatives through system knowledge and analysis throughout the continuum from assessment to project close. Develop and maintain project documentation and/or reporting according to project management standards. Review status reports and modify schedules and plans as required. Prepare status reports and keep management, customers and others informed of project status. Keep track of and document issues and decisions that impact the project/initiative. Provide key communication between department and projects assigned to monitor impact to Provider Reimbursement and keep Provider Reimbursement Management Team informed and coordinate transition plans.
              • --Assists with other special projects or work as necessary.--RequirementsEDUCATION: (Minimum education & certifications required)A Bachelor's Degree is required, preferably in health care management, business, or related field (equivalent experience may be considered).EXPERIENCE: (Years of experience)The position requires 3-5 years experience in a functional business area, preferably in a healthcare environment. Previous project coordinator/management experience preferred. The Business Analyst Senior will have familiarity with project management concepts and an understanding of the pricing system(s) and IT testing processes.Required 2-3 years of combined experience in a business environment, preferably healthcare industry. Proficiency in use of computers, specifically Microsoft Office, including Microsoft Project and Visio. Knowledge of project management concepts and applications preferably obtained through a formal training program.--Knowledge of Provider Reimbursement department structure/model and TAHPMaster/Diamond claims functionality, logic and processes preferred.SKILL REQUIREMENTS: (Include interpersonal skills)
                • Extensive technical aptitude to understand complex systems and programming logic
                • Data and reporting analytic ability to support project and issue resolution
                • Proven ability to assume a leadership role within workgroups and projects.
                • Must be able to work collaboratively and cooperatively as a team member, fostering and atmosphere of trust and respect.
                • Must be highly organized and self-directed, with proven ability to work independently and in team settings on projects of diverse nature.
                • Ability to plan outcomes for a work group session and manage group dynamics to effectively reach a positive meeting outcome.
                • Requires attention to detail to accomplish all tasks. Ability to maintain focus on the scope and desired outcomes.
                • Ability to make recommendations on those that best meets project and corporate objectives.
                • Ability to be flexible and a proponent of change. Ability to envision the impact of change and ways to do business.
                • Must possess initiative, balanced judgment, objectivity and the ability to plan and prioritize one's own work to assure maximum efficiency.
                • Demonstrated ability to synthesize and process complex information and deliver the information, both verbally and written, in a clear, concise, and articulate manner. Requires strong verbal and written skills to effectively communicate at both detail and summary levels to THP management.
                • Requires excellent interpersonal skills in order to communicate and work with staff of all skill and experience levels. Must be able to exercise patience and high level of diplomacy to recognize politically sensitive issuesWORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)
                  • Fast paced office environment handling multiple demands.
                  • Must be able to exercise appropriate judgment.
                  • Extensive use of PC required and moderate phone usage.
                  • May require occasional weekend hours or evening hours as the needs of the organization/project dictate.--
                  • May require occasional travel to vendor sites and clients or attendance at seminarsWhat we build together changes our customer's health for the better.We are looking for talented and innovative people to join our team.Come join us! Posted Today Full time R2165 About Us A nonprofit organization founded in 1979, Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. We strive to improve the health and wellness of the diverse communities we serve. Our employees are hard-working, innovative, and collaborative. They look for opportunities to grow and make a difference, and they help make us one of the Top Places to work in the area.--

Keywords: Tufts Health Plan, Canton , Business Analyst Senior - Provider Reimbursement, Professions , Canton, Michigan

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