Business Analyst, Quality & Business Performance

We are seeking a Business Analyst to join our operational performance team. This isn't just a data entry role—it's a "detective" role. You will be responsible for analyzing, documenting, and optimizing business processes that directly impact healthcare delivery. By bridging the gap between data and operations, you will identify trends, troubleshoot validation workflows, and implement solutions that drive efficiency and compliance.

What You Will Do

• Data Intelligence: Design and conduct deep-dive analysis across multiple datasets to uncover patterns and opportunities for healthcare process improvement.
• Process Documentation: Build and maintain detailed workflows, data models, and use cases for all analytics performed.
• Stakeholder Collaboration: Facilitate workshops to prioritize business needs and deliver compelling presentations that translate technical findings into executive-level recommendations.
• Systems Support: Assist in the design and implementation of healthcare IT solutions, ensuring they meet both business goals and strict regulatory requirements.
• Performance Monitoring: Evaluate the long-term effectiveness of implemented solutions and pivot strategies based on data-driven results.

What You Will Bring

• Experience: 3–5 years in a health plan or healthcare services environment, with at least 3 years specifically focused on healthcare operations, authorizations, or claims.
• Technical Mastery (Non-Negotiable): You must be an Expert in Excel, specifically with Chart Control and Power Query.
• Analytics Toolkit: Proficiency in Tableau, Power BI, SQL, and other data visualization tools.
• Education: Bachelor’s degree in Business, Health Informatics, or a related field (or 7 years of direct experience). A Master’s degree or certifications (CBAP, CCBA, PMP) are highly preferred.
• Regulatory Knowledge: Solid understanding of HIPAA, CMS guidelines, and payer-specific rules.
• Systems Thinking: A proven track record of process improvement and automation within quality or business performance workflows

Location: 100% Remote (Must reside on the East Coast)

Citizenship: Must be a US Citizen or Green Card Holder