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Business Analyst - Healthcare Pricing

at Signature Performance, Inc. in Portland, Maine, United States

Job Description

This is a remote based position. Applicants can be located nationwide

 

 

 

 

Status

Full-time

 

Job Description

 

 

Who We Are:

Signature Performance is working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and making the lives of the people we work with better. We do that by leading with our values of Passion, Courage, Integrity and Respect in all interactions.

This is an exciting time for Signature Performance, as we continue to aim to be the foremost healthcare administrative services company in the industry. This growth includes expanding upon a robust technology platform and automated processes while attracting the industry's best technical talent.

If you are interested in joining a growing technology team, focused on healthcare administrative processes, at a company committed to delivering the highest performance to our clients, partners, allies, and colleagues, this is the team for you.

What We Offer:

Signature believes in fully developing each one of our Associates. We deliver a performance-driven atmosphere with competitive pay and bonus structure, world-class training and development classes, resources, and events, an award-winning culture to thrive in, and so much more.

Tuition Assistance Program

401(k) program with employer contributions

Comprehensive health insurance

Competitive Paid Time Off for Sick and Vacation Time

No-cost annual flu shots

A hybrid work-from-home and/or on-campus work plan - this position is Full Time Remote Eligible.

Job Description:

The Business Analyst for Healthcare Pricing designs, implements, supports, and validates Provider Network (Physicians, Clinics, Pharmacies, etc.) and Client pricing constructs. This position includes monitoring of subscriber data feeds and related loads to assure systemic risks are identified and corrected, and audit and analysis of automated provider and client related pricing architecture and algorithms.

Success in this position includes assisting in the growth and maintenance of our software solutions by researching industry changes and data sets, analyzing data trends, identifying areas of opportunity, and aiding in the implementation of these enhancements.

Ideal candidates should have a naturally analytical way of thinking, be able to quantitatively and qualitatively analyze information, be process oriented, and enjoy research and team collaborations.

The ideal candidate will demonstrate strong technical skills, will be familiar with the healthcare and health insurance industry, and will have experience interpreting volumes of technical information to define requirements for use during gap analysis and technical solution design.

Basic Qualifications:

Bachelor's degree or higher in business, healthcare administration, information systems, computer science, finance, accounting, mathematics, or a related field of study

Minimum of two (2) years of experience in business analysis including requirements gathering and specification documentation

1+ years of experience with provider payment methodologies and healthcare products

Preferred Qualifications:

Knowledge of Atlassian Jira and Confluence a plus

Expectations:

Expertise in performing gap analysis, issue analysis, root cause assessment, and resolution planning

Understanding of professional and institutional claims processing and adjudication

Analytical experience in financial analysis, health care pricing, network management, health care economics or related discipline

Knowledge of medical claims pricing factors such as pricing sequences, lessor of logic, specialty networks, upcharges, and carve-outs based on Product, Provider, or State Jurisdiction

Advanced technical skills

Strong planning, organizational, and time management skills

Superior analytical and conceptual thinking skills

Excellent verbal and written communication

Excellent documentation skills

Experience creating detailed reports and giving presentation

Ability to influence stakeholders and work closely with them to determine acceptable solutions

Competency in Microsoft applications including Word, Excel, and Outlook

Familiarity with relational databases (SQL)

Additional Information:

Applicants must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.

Certain positions may be subject to additional background screening depending on client need and access to certain systems.

This position will require you to have the ability to effectively operate the current computer system, telephone system, and other office machines such as copier and fax machines.

You will be responsible for conducting business and... For full info follow application link.

 

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

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Job Posting: 638158

Posted On: Nov 11, 2021

Updated On: Dec 09, 2021