Virginia Premier Health Plan, Inc.

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Operations Analyst II

Operations Analyst II

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4226

Job Description

Overview

The Operations Analyst is responsible for the data analysis, process engineering, report development and generation for the Member Operations department. This position is responsible for developing an extensive expertise in the IDX Managed Care Application (MCA), QNXT and all interface applications, both customized and packaged.

 

An Operations Analyst II may be the primary contact for one or more system interface applications and is expected to provide a high level of expertise with matters relating to this interface and its functionality.

 

Responsibilities

  • Develop and analyzes business performance reports for transportation, call center and enrollment data; provides notations of performance deviations and anomalies
  • Perform monthly enrollment process
  • Perform complex data analysis and report writing to identify trends
  • Create complex queries. Apply extensive understanding of database tables, relations, data types and values
  • Develop an expertise in GE MCA report functionality, including DBMS, UM, and other standard report systems
  • Initiate process improvement and automation from concept to implementation
  • Document applications for use in training, maintenance, and department procedures
  • Research, gather and document requirements for adhoc reporting, project initiatives for new vendor, or business development opportunities.
  • Monitor, test and support system changes for applications
  • Develop advanced knowledge in referral module and interface with transportation scheduling/dispatch system
  • Create and modify transportation requests entered into transportation scheduling/dispatch system
  • Analyze issues related to transportation reimbursement process and make recommendations to management for resolutions.
  • Build advanced reports and filters using call center reporting software
  • Ensure programs and business processes meet necessary requirements and are accurately captured in Process Maps and SOPs.
  • Attend meetings, compiles and publishes meeting minutes along with deliverables and other requirements.
  • Confidently works with all levels within the organization to accomplish project goals
  • Performs other duties as assigned

Qualifications

 MINIMUM EDUCATION REQUIREMENTS 

  • Bachelor’s degree in Business, Mathematics, Economics, Information Systems or related technical field
  • Lean Six Sigma certification preferred 

SPECIAL KNOWLEDGE AND/OR SKILLS 

  • Proficient knowledge of SQL queries to include ability to create and populate databases, perform data normalization, create query analysis, conduct table indexing, perform multiple joins, and comfortable use of functions (average, count, sum, etc.)
  • Healthcare with Medicare and/or Medicaid Operations preferred
  • Strong quantitative, analytical, organizational and problem solving skills
  • Experience in health insurance claims processing, operational and/or data analysis experience; knowledge in database structures and standard query and reporting tools
  • Proficient in statistical use of Microsoft Excel, to include comfortably utilizing functions, developing charts and graphs, inserting formulas, performing Lookups, sorting and filtering data
  • Proficient in Microsoft Access, to include ability to create customs forms, create reports, create lookup and parameters, and utilize function/expression building
  • Proficient knowledge of flow charting/process mapping
  • Experience in process management and process optimization preferred 

WORK BACKGROUND/EXPERIENCE

  • A minimum of one year related experience
  • One or more years’ experience as a data, systems or business analyst
  • One or more years business or Healthcare related experience

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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