Company Name:
Concerto Healthcare
Approximate Salary:

Location:
Irvine, California
Country:
United States
Industry:
Business Development
Position type:
Unspecified
Experience level:
Education level:

Sr. Business Analyst, Operations


Concerto Healthcare


ConcertoHealth and its subsidiaries are an Equal Opportunity Employer. We do not and will not discriminate in employment or personnel practices on the basis of race, color, religion, national origin, ancestry, alienage or citizenship status, age, disability, sex, sexual orientation or any other characteristic protected by applicable federal, state or local laws.

Job ID 2017-2209
Job Location US-CA-Irvine
Category Operations
Type Regular Full-Time


Overview:


ConcertoHealth Inc. is the leading provider of specialized primary care and supporting clinical services for complex, frail, elderly, and dual-eligible patients. Operating exclusively in value-based agreements, ConcertoHealth provides high-touch, individualized care for patients, and deploys wraparound clinical resources to extend the reach of primary care practices. This comprehensive medical management solution, elevated by Concerto's proprietary population health technology, improves overall healthcare quality and patient outcomes, benefitting payers and their provider networks. The company is headquartered in Irvine, Ca. For more information, please visitwww.concertohealth.com.

The Sr. Business Analyst will support the development and operational execution of care management processes throughout the organization, inclusive of reporting, process documentation, audit support, and implementation needs.


Responsibilities:


  • Development of operational reports, including validating regulatory reports for our delegated arrangements and building or defining reporting business rules as needed
  • Develop, assess & implement care management processes and process improvements
  • Facilitate collaboration between Care Management (CM), Utilization (UM) and Care Center (clinic) Operations
  • Monitor care management compliance with contract requirements, & support the development of improvement strategies, as needed
  • Create/update process flows for Care Management programs and functions
  • Support client audits and regulatory reporting needs related to care management
  • Regularly assess policy and procedure or other protocols, develop and manage Care Management protocols, policy, flows and procedures
  • Support process development for CM operational programs
  • Develop and maintain functional expertise regarding care management systems including reporting dashboards and scorecards oversight
  • Collaborate with operations trainer and other functional departments
  • Provide oversight of care management operations systems dashboards, including audit sampling to validate/maintain systems integrity
  • Conduct analytics on available data regarding Care Management operations, and recommend areas for improvement
  • Prepare internal reports and presentations in support of client and leadership meetings and other related meetings
  • Interview Subject Matter Experts, assimilate, and document business requirements for the technology development team related to Care Management
  • Conduct User Acceptance Testing for IT development related to Care Management
  • Review client agreements and analyze and document Care Management requirements
  • Serve as Project Manager for key Care Management initiatives
  • Other duties as assigned


Qualifications:


  • Required Bachelor's Degree, business analysis experience
  • Preference for degree in nursing or other healthcare related field
  • MHA, PMP preferred
  • Minimum: 5 years clinical operations and development experience
  • Will consider 10+ proven clinical operations and program development experience and education
  • Preferred candidates will have previous experience in a healthcare setting
  • Demonstrated success serving business clients, and experience in developing and implementing change initiatives
  • Demonstrated experience serving in both strategic and operational roles
  • Strong interpersonal and communication skills, both verbal and written
  • Strong organization skills
  • Goal-oriented, must be able to meet deadlines
  • Ability to maintain professional and positive behavior
  • Travel domestically 20%




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