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Business Analyst - Medicare

Philadelphia, Pennsylvania, United States
November 10, 2016

Job Type: Contract to Hire

Contract: 3 Months

Build repeatable automated reports to support all functional areas including but not limited to Enrollment, Customer Service, Claims, Finance, Encounters, Reconciliation and Medical Management to support operational excellence across all Products. Develop Complex reporting to support oversight capabilities and ensure performance standards meet all Plan, State and CMS audit and Star requirements. Support creative solutions to mitigate real-time business break fix’s following a three pronged agile approach inclusive of developing short, mid and long term automated solutions. Provide analytics to help re-engineer existing business processes to gain efficiencies and reduce manual intervention utilizing agile three pronged approach. Develop ad-hoc and repeatable State, CMS and internal reporting as needed. Ability to maneuver through all systems test environment to support preliminary testing of all work. Interface directly with the Process Improvement Analysts (PIA) to secure and understand technical requirements with the ability to translate into IS language and code development. Collaborate and develop strong business partnerships with the Medicare IS, Compliance and Business Owners of each functional area along with the Enterprise IS, EDI, Medical Economics, Quality Assurance and Operations teams.


• Requires extensive operational systems experience, IS knowledge and understanding of IS technical terms.

• Proficiency in translating functional requirements into code development. Ability to create procedures and Scripts.

• Excels in data manipulation and reporting

• Thorough understanding of data bases and, file transfer protocols.

• Solid understanding of MMS Keyword File scripting

• Advanced knowledge of ETL (Extract, Transform and Load), SSIS (SQL Server Integrated Services), SQL Server Business Intelligence Development Studio, and SQL Server Management Studio, Excel, Access, Visio and MS office skills.

• Bachelor’s Degree or equivalent work experience

• One to three years Medicare Advantage or Business Analysis

• CMS Medicare technical experience and understanding of regulatory requirements

• Microsoft Excel, Microsoft Access, Microsoft Word, Microsoft SQL, SSIS, Crystal Reports