Senior Business Analyst - External

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aspx The Company: AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population.
We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers.
Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all.
This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment.
As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.
The Culture: AlohaCare employees share a passion for helping Hawaii’s most underserved communities.
This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs.
AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees.
Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings.
AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.
These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.
The Opportunity: Internal Senior Business Analyst The Internal Senior Business Analyst will serve as the technical liaison between the IT department and various internal business units in support of the development and enhancements to various systems associated with the organization.
The internal responsibilities of this position consist of developing a deep knowledge of supported health plan areas, conducting business requirement sessions, documenting current and to-be process flows, and creating detailed requirement documents to support development or configuration changes to the various processes and systems.
This position will support testing within the business units by creating test cases and assisting all business areas with the quality assurance process.
To support project planning, they will work directly with the business unit manager of the various areas and other key employees involved in each project to identify, define, prioritize, and execute projects which deliver value through the implementation of new or existing systems – which meets the user’s expectations.
External Senior Business Analyst The External Senior Business Analyst will serve as the technical/project liaison between the IT department, internal business units, and external stakeholders.
The focus of this position is to foster the technical relationship with external stakeholders to ensure that all AlohaCare initiatives are communicated and managed effectively.
This position will be responsible for onsite visits to the external stakeholders and work with their technical teams and business units to provide support in meeting the AlohaCare goals related to Quality, infrastructure, and technical projects.
Primary Duties and Responsibilities: Internal Duties and Responsibilities • Reports to the Senior Director of Business Support Services and communicates any important information about the organization or in-flight projects to other employees in the IT department.
• Perform project management duties for AlohaCare on upgrades, new releases, process improvement tasks, compliance projects, and any other project or task related to their assigned business areas.
• Oversees all project management on core software system implementations.
This includes organizing meetings, keeping task lists, interfacing with AlohaCare users and the vendor implementing fixes and resolving issues.
• Work in collaboration with the manager and staff of the business units involved to develop solutions for all identified problems.
• Work with the manager and staff of the business units involved to identify areas of improvement and execute process improvement projects that will automate current manual processes that will meet all regulatory requirements.
• Troubleshoot all process and system issues when they arise and work with the various staff members and vendors when necessary to resolve the problems in a timely manner.
• Work with all business units and understand reporting requirements and will lead all projects with the necessary staff and/or vendors to develop or modify new and existing reports and will also work with the internal Business Intelligence department to get the required reports created in the BI software.
• Develops and manages all team and vendor meetings on any project or process improvement engagement.
• Develops and delivers informative and well-organized presentations to staff.
• Exhibits confidence and an extensive knowledge of emerging industry practices when solving business problems.
• Uses creative thinking beyond the boundary of existing industry practices and staff mindset.
• Other related duties as may be assigned by the CIO or an IT manager.
Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality.
Employees have access to AlohaCare data based on the data classification assigned to this job title.
External Duties and Responsibilities • Reports to the Senior Director of Business Support Services and communicates any important information about the organization or in-flight projects to other employees in the IT department.
• Perform project management duties for AlohaCare on process improvement tasks, compliance projects, and any other project or task related to external entities.
• Oversees all project management on external projects.
This includes organizing meetings, keeping task lists, interfacing with AlohaCare users, external parties, and the vendors involved.
• Work in collaboration with the manager and staff of any business unit involved to develop solutions for all identified problems that arise.
• When necessary, work with the manager and staff of the business units involved with external projects to identify areas of improvement and execute process improvement projects that will automate current manual processes for external stakeholders.
• Work with all business units and understand reporting requirements and will lead all projects with the necessary staff and/or vendors to develop or modify new and existing reports and will also work with the internal Business Intelligence department to get the required reports created in the BI software.
• Develops and delivers informative and well-organized presentations to staff.
Work with the external users such as CHCs, Providers, and AlohaCare employees to help with any issues related to any external projects.
• Exhibits confidence and an extensive knowledge of emerging industry practices when solving business problems.
• Uses creative thinking beyond the boundary of existing industry practices and staff mindset.
• Other related duties as may be assigned by the CIO or an IT manager.
Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality.
Employees have access to AlohaCare data based on the data classification assigned to this job title.
Interface with providers and internal staff on HEDIS data gathering activities related to third-party population health systems (AZARA, i2i).
Manage the HEDIS data extract processes only and not the whole HEDIS initiative.
Work with the providers on any project where they need internal help with any AlohaCare system or process.
This could be helping to train providers or putting processes in place at the provider location to run reports or help configure the system with the provider.
Work with the CHCs or the other provider community with IT projects that have a joint purpose.
This could be working with the provider to understand AC-Online better, helping with batch membership verification (270/271), or EPSDT projects.
Requirements: (internal and external) Bachelor's Degree (in Computer Science, Business Administration, Public Health, Management or other related field) or equivalent combinations of education and experience 5 years of relevant experience.
Strong verbal and written communication in English.
Requires operation of general office equipment to include; PC, fax/copy machine and ACD Mitel Phones.
Advanced skills using Microsoft Programs; Word, Excel, Outlook, and PowerPoint.
Strong organizational skills.
Positive attitude and ability to accept direction.
Excellent attendance, must be punctual and reliable Flexibility and adaptability to changing priorities.
Available for weekend or extra hours work during project implementation or whenever necessary to accomplish tasks.
Must be able to telecommute if necessary using personal equipment External Requirements: Possession of valid driver’s license with access to a reliable insured automobile Personal Transportation for onsite visits to AlohaCare stakeholders Preferred Requirements: • Bachelor's Degree in Computer Science, Business Administration, Public Health, Management or other related field.
• 5 years of QNXT experience or other claims processing systems.
• 5 years of GuidingCare experience or other care management systems.
• Intermediate Transact-SQL Skills • Health Catalyst experience.
• Previous experience creating user manuals, project plans, and user documentation.
• Working knowledge of healthcare industry.
• Previous experience with the Quest/QI Medicaid and/or and Medicare program.
• PMI-PBA or CBAP Certification.
Mental, Physical and Environmental Demands: Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.
Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.
Inside working conditions No environmental hazards Requires operation of general office equipment to include PC Salary Range: $65,000 - $95,000 annually AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws.
Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.