Business Analyst (Process Improvement / Clinical Operations)

This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this time.

Position Summary

The Clinical Operations Support Department (CS) is responsible for providing analytical and operational support to different departments within Clinical Operations in order to maximize productivity and to ensure regulatory compliance.

The Senior Business Analyst, Clinical Operations reports to the Director, Clinical Operations Support.

This role will provide significant BA support to key business units within Clinical Operations, including reports and analytics to ensure continuous process improvement. As a senior individual contributor on the team, the Senior Analyst is expected to successfully lead projects of any size, scope, and level of complexity, directly engaging with senior leaders of the highest level. He/she is also expected to mentor and guide more junior members of the team.

This role is for an independent self-driven contributor who will lead delivery of projects/reports/analytics and may work independently or in matrixed cross functional team. The expectation is this person can lead a workgroup and mentor team members, as needed

Supervision Exercised: None

Essential Duties & Responsibilities

Reports and Tools

• Engages with stakeholders to understand current processes/systems and pain points as well as elicit detailed business needs of/gather requirements for reports and tools.
• Develops reports by querying the database using SQL or any related programming language and analyzing data to ensure accuracy
• Creates visualizations using Tableau, Looker, Excel

Data Analysis

• Analyzes large sets of data, summarizes and presents results.
• Develops and analyzes quantitative reports to assess utilization, productivity and adherence to policies and procedures related to various topics such as, authorizations, assessments, procurement, etc.
• Tracks, analyzes and resolves claims issues related to prior authorizations.

Process Improvement

• Partners with Clinical Operations management to develop and review workflows, to streamline processes and increase efficiency.
• Generate insights and developing recommendations for solutions
• Create Visio diagrams or other visualizations to use in prototype review sessions

Liaison between Clinical Operations and Other Departments

• Plays a leadership role in developing and managing major Clinical Operations Analytic projects
• Serve as liaison between Business Intelligence team and various departments within Clinical Operations. He/she is expected to translate the business needs into BI requirements for reports, dashboards and tools.

Education (Required)

• Bachelor's Degree in information systems or related quantitative field required (Business, Computer Science, Mathematics, Finance, Economics, or similar)

Experience (Required)

• 5 years minimum experience with at least 2 years in demonstrated a leadership role
• Demonstrated progression of leadership, responsibility, knowledge, and experience
• Demonstrated experience in understanding business needs and documenting requirements for reports and tools.
• 5 years of programming experience in SQL or any related programming language
• 5 years of experience in developing and using large relational database modeling concepts and practices
• Demonstrated experience with data or statistical analysis in healthcare industry/operations Demonstrated experience with BI products like, Tableau, Alteryx, Looker
• Demonstrated experience in developing and using large relational databases
• Experience with Google Cloud (big query) preferred

Knowledge, Skills & Abilities (Required)

• Expertise with technical programming languages such as SQL or any related language
• Advanced knowledge of Excel, including the use of Macros and VBA
• Proven ability to summarize data and build effective visualizations
• Proven ability to translate business needs into BI requirements
• Knowledge of operations in healthcare preferred
• Knowledge of R, Python and SAS preferred
• Strong problem-solving skills
• Proven skills and judgment necessary for independent decision-making
• Strong communication skills both written and verbal

Language(s): English required, bilingual preferred.

Compensation Range/Target: $64,000 - $96,000

Commonwealth Care Alliance takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.