Clinical Business Analyst (Managed Care Needed)
Clinical Business Analyst (Managed Care Needed)
Experience: 5-7 years
Bonus: Yes
Relocation: Yes
Works collaboratively with various levels of clinical staff and Information Systems staff to clarify needs, prioritize requests, and recommend workflow enhancements. Responsible for evaluating and documenting clinical processes, including step actions and workflows to construct and enhance the clinical model of care.
Essential Functions:
- Acts as subject matter expert for an assigned work stream unit - Intake, UM, CM, DM, Reporting or Appeals.
- Assists in the documentation and gathering of detailed requirements and workflow processes and analysis.
- Reviews current workflow and leads recommendations and defines requirements to build processes and forms needed to support the business in the new system.
- Recommends and implements software based on best practices.
- Analyzes customer needs and identifies system and procedural solutions to enhance the clinical practices.
- Identifies opportunities to leverage technologies in areas that improve and promote the clinical agenda.
- Performs gap analysis.
- Identifies needed process changes to ensure compliance with the use of technology to optimize care delivery processes and effectively communicate patient care activities.
- Performs application testing and creates test scripts – SIT/UAT.
- Develops and creates test plans for SIT and UAT.
- Works with IT to resolve update issues.
- Communicates with Clinical Architect Leads to obtain sign-offs.
- Ensures updates are tested and applied on a timely basis.
- Provides documentation and training as needed.
- Ensures technology meets Compliance and Regulatory Requirements.
- Performs other duties as assigned.
Candidate Education:
- Required: Bachelor's Degree in a health sciences field
- Required or equivalent work experience: 5+ years clinical experience with active RN/LPN/MD/DO/ARNP/RT/Phar.D. license in a managed care setting
Candidate Experience:
- Required: 5+ years of experience in a position that requires participation in and knowledge of Care Management operations and regulations that affect clinical processes and reporting
Technical Skills:
- Required: Intermediate Microsoft Outlook
- Required: Intermediate Microsoft Word
- Required: Intermediate Microsoft PowerPoint
- Required: Advanced Microsoft Excel
- Required: Intermediate Microsoft Access
- Required: Advanced Microsoft Visio
Does this describe you?
- Does this candidate have experience with Managed Care?
- Does this candidate have an active LPN or RN?
- Does this candidate have experience with Microsoft Visio?
- Does this candidate have experience with UAT?
- Does this candidate have experience within a clinical environment?
- Does this candidate have experience conducting analytics within a healthcare environment?
All your information will be kept confidential according to EEO guidelines.
Direct Staffing Inc
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