BusinessOperations - Exception Template
Listed on 2026-02-01
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Healthcare
Healthcare Administration, Healthcare Management
Overview
NON-IT BUSINESS ANALYST 3
EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Position PurposePerform various analysis and interpretation to link business needs and objectives for assigned function.
Education/ExperienceBachelor’s degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred.
Benefits and Payment ConfigurationBachelor’s degree in related field or equivalent experience. 4+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred.
Compliance Coding/Prepay Compliance (Payment Integrity)Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements). Experience in healthcare industry, preferably with managed care techniques and administrative philosophy. Experience in claims coding analysis or medical claim review/research preferred. Knowledge of Amisys claims payment system and Business Objects preferred.
EncountersBachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 3+ years of managed care encounters experience. Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred.
MedicareBachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements). Experience in healthcare industry, preferably with managed care techniques and administrative philosophy. Experience in managed health care experience, preferably with Medicare. Experience working with and leading diverse teams in matrix managed environments. Project management experience preferred.
Provider DataBachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (documenting business process, gathering requirements) experience in healthcare industry and/or working in a data driven environment. Knowledge of data migration, software enhancement/planning, and Agile preferred. Experience managing projects with a high reliance on technology.
Member & Provider SolutionsBachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry and/or customer service or enrollment functions. Experience managing projects with a high reliance on technology. Knowledge of data integration, software enhancements/planning and Agile preferred.
Story Behind the Need- What is the purpose of this team?
- Describe the surrounding team (team culture, work environment, etc.) & key projects.
- Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative?
- Strategic Business Operations is accountable for several cross-functional areas for the organization, including activities within Provider Operations like ownership of various organizational initiatives, supporting the team in ensuring accurate Medicaid/CHIP provider registration and provider directory accuracy, business analysis which focuses on ensuring accurate and reliable documentation for stakeholders for a distinct set of projects.
- This position operates with a high level of autonomy working with a cross-functional group and will have the support of leadership to achieve key objectives. Demonstrate the ability to think critically beyond task completion by…
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