Job Summary:

The Health Plan Operations Analyst I reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems and participates in development of solutions to improve or further leverage these functions.

Essential Functions:

• Participates in the development of new market operation initiatives from concept to implementation and provide statistics measuring progress throughout

• Market process issues
  • ID card issue resolving wrong co-pay information.
  • Helping to align the mismatches in our Single Case Agreements where policy does not match market direction and operations is doing something completely different (project facilitation).
• Marketplace state competitive analysis.Bringing existing membership numbers, eligibility numbers and local competitive intelligence together to facilitate and make decisions with market president.
• Assist Market President, BD and Operations with project management or NC Medicaid contract

• Collect and analyze data in support of business case creation and realization
• Contribute to ensuring operational effectiveness by assisting in the development of strategic plans for market operations, including business, financial, and operational goals and objectives
• Assist in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information
• Develop, document and perform testing and validation as needed
• Work with peers to achieve cross-functional capability with project execution and subject matter expertise
• Participates in the discussions of challenging the standard thinking with new ideas, approaches, and solutions which focus on process improvement and growth
• Perform any other job duties as requested

Education and Experience:

• Bachelor's degree in Engineering, Business, Finance, Economics or related field or equivalent years of relevant work experience is required
• Minimum of one (1) years of analytical experience is preferred
• A minimum of three (3) years of health care operations or project management experience is preferred

Competencies, Knowledge and Skills:

• Advanced proficiency in Microsoft Office Suite to include Word, Excel, Access and PowerPoint
• Familiar with a variety of analysis concepts, practices and procedures
• Excellent written and verbal communication, facilitation and presentation skills
• Strong interpersonal skills and high level of professionalism
• Effective listening and critical thinking skills
• Effective problem solving skills with attention to detail
• Ability to work independently and within a team
• Strong analytical skills
• Ability to create and maintain excellent working relationships
• Time management skills, ability to develop, prioritize and accomplish goals with a sense of urgency
• Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
• Ability to multi-task and remain flexible during organizational and/or business changes

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for long periods of time
• May be required to travel occasionally

Compensation Range:
$52,400.00 - $83,900.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

Competencies: