We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

KHS reasonably expects to pay starting compensation for the full-time position of Delegation Oversight Business Analyst, in the range of $30.20 - $40.05 hourly.

Our Mission
Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

General Purpose

This position is responsible for providing business analysis and reporting of healthcare information as it relates to Delegation Oversight functions. The Delegation Oversight Business Analyst will support evaluation and oversight of various responsibilities delegated to subcontracted entities, per regulatory and contractual requirements. The Delegation Oversight Business Analyst is responsible for developing a complete understanding of the actual needs of Delegation Oversight stakeholders, not simply their expressed desires, through a methodical analytic process and is capable of exposing data reporting requirements. The Delegation Oversight Business Analyst will possess the skills necessary for report writing and presentation development contributing to the company’s project efforts while maintaining data integrity. This position assists management in defining the technical and reporting needs of the department and facilitates or governs analytical discussions between various teams.

Essential Duties And Responsibilities

General

Provide support across delegation assessments, status reports, and joint operations meetings with all delegated entities including tracking action items and ensuring follow up is conducted to close action items.
Manage compliance related to our community of delegated organizations and entities.
Act as a liaison between Delegation Oversight and other KHS departments on corporate projects to oversee department deliverables for such projects.
Participate and contribute in Agile and Project Management methodologies through planning to execution (i.e. requirements gathering; decomposition, development, etc.) in support of department or corporate projects.

Analytical

Engage regularly with Business teams and Business Intelligence resources in support of business processes and projects that contribute to the achievement of the organization’s strategic goals set out by the Board of Directors and Chief Executive Officer.
Advanced skills in analysis and understanding of operational questions as to why a certain performance indicator exists in the data and how it can bring meaningful context with a clear presentation to Director level management.
Advanced understanding of the influence data, created or used by departments, has on Delegation Oversight operations and the ability to document or investigate issues as to why a certain behavior or outcomes are exhibited through data metrics.
Perform research on various issues related to operations, sustainability, and other related fields.
Ability to analyze and synthesize complex information provided by a large number of people who interact with the business, such as customers, staff, IT professionals, and executives.

Reporting

Clearly and concisely articulate operational needs of the Delegation Oversight department and various business owners with overlapping interests.
Coordinate the data and reporting needs specific to delegated entities, vendor contracting, financial lifecycles, and regular performance reports.
Critically evaluate and audit information gathered from multiple sources, reconcile conflicts, and distinguish user requests from the underlying true needs.
Work closely with the Manager of Delegation Oversight to assist in reviewing rate changes, utilization, and credentialing reports to oversee delegate scope of services including fees and payment schedules.
Monitor monthly/quarter/annual data submissions by working closely with Delegation Oversight and Credentialing team members to design auditing plans meeting regulatory requirements per state and federal requirements (DHCS/DMHC/NCQA/CMS) as needed.

Project Requirements

Assist in gathering and understanding business requirements through meetings, document reviews and other data collection methods.
Advanced skills in the use of analytical reasoning to understand the end user's requirements and transform the requirements into operational application.
Demonstrated experience on how to deconstruct high-level information into details and abstract up from the low-level information into generalized results.

Technical

Advanced Microsoft Office (Word, Excel, Power Point, and Outlook) skills including experience creating charts, templates, pivot tables, formulas and calculations in Microsoft Excel.
Experience with, or able to learn, business software and manual systems (i.e. Symplr Provider, QNXT, JIVA, etc.) in order to bring efficient and effective changes for better performance and more accurate information and reporting.
This position must understand the organization’s data structures and software analytical tools (Business Objects, Excel, Visio, and SQL.) for departmental analytics and processing.
Perform data collection for manual processes, auditing, and analysis.

Communications

Deliver complex analytic products in a professional report format, presentation, or verbally, to management with adherence to specifications and timelines and thoughtful evaluation of the analysis and results.
Strong verbal and written communication skills with the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.
Facilitate meetings or communications as an interface between business units, technology teams, and other support resources.

Qualifications And Experience

Must be a “self-starter” with a strong sense of initiative and follow-through. Ability to work independently under high-pressure circumstances with little or no supervision.
Educational experience in data analysis methodologies and techniques.
Highly organized individual that is willing to accept responsibility, demonstrate good judgment, initiative, and resourcefulness, and is able to adapt and learn quickly.

Employment Standards

Bachelor's degree in Business, Statistics, Mathematics, from an accredited school; or related field with an academic demonstration of analytical skills required; AND two (2) years' working experience with a Managed Care Organization (MCO) or similar type organization;

Six (6) years of experience in a business analytical capacity with a minimum of three (3) years acting primarily in a business analytical capacity with a Managed Care Organization (MCO) required;

Equivalent combination of education and business analytical experience on a year for year exchange of experience for education to be reviewed individually by Human Resources.

Required travel up to 10%. Possession of valid California Driver’s License and proof of valid State required auto liability insurance.

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

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Kern Health Systems

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Delegation Oversight Business Analyst