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Sr. Operations Analyst

Job Category: Service Operations

Location: Lake Mary, FL, United States

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Job Description


The Senior Operations Analyst (SOA) is responsible for tracking, reporting, analyzing and summarizing operations data. The SOA position assists with the maintenance and testing of all system related changes; including workflows, validations, and automated processes. The SOA runs and reconciles reports. The SOA owns the accuracy and timeliness of reported data as well as communication and resolution of identified issues involving reports and trends. This position must coordinate work within and between departments as well as the state or external vendors to ensure regulatory and compliance guidelines are met.

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  • Develop workflows and processes to ensure accurate processing and reconciliation occurs.
  • Run queries identifying and analyzing data across multiple data sources and create report cards for prospective and current Department’s initiatives.
  • Build and maintain positive relationships with internal and external business partners and customers.
  • Assist Operations Analysts through training, coaching and functioning as first-level of support
  • Complete daily, weekly and monthly analysis, reports, summaries and dashboards
  • Receive and respond to inquiries and complaints and interface with internal and external personnel
  • Support audit, compliance and regulatory responsibilities
  • Meet SLA guidelines in creating files, reconciling information, executing system batches, etc.
  • Analyze business processes, identify root causes and provide data-based insights and recommendations for process improvements
  • Access and analyze data across multiple systems to identify areas of risk, complete root cause analysis to determine key drivers and develop recommendations to mitigate; report findings and recommendations to management.
  • Participate in systems testing and validation for various operations systems
  • Work directly with other teams or business units as a subject matter expert to understand objectives and codependences to ensure consistency
  • Maintain and execute basic and complex data queries to generate required data sets. Maintain and execute routine queries
  • Additional duties as assigned  

Minimum Qualifications:  

  • Bachelor's Degree from an accredited institution or equivalent work experience
  • Analysis experience using SQL, Excel and/or Access
  • Must be able to manipulate and create Excel spreadsheets; which will include standardizing reports, utilizing v-Lookups, pivot tables, filtering and formulas to generate desired results.
  • Must be familiar with Access as a database management to manipulate queries, identifying risks, issues and providing resolution options

Preferred Qualifications:

  • Work experience in health insurance or healthcare environment
  • Experience with SAS
  • Knowledge of MHS and CRM systems
  • Working experience with  Medicaid programs, regulations and reimbursement
  • Working experience with NYSoH or Federal Exchange
  • Strong analysis and report development skills
  • Ability to demonstrate effective verbal and written communication 

Compliance & Regulatory Responsibilities: See Above

License/Certification: NA

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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