| High Priority-Healthcare Business Analyst Sr -Southfield, MI -One day-week) at Southfield, Michigan, USA |
| Email: [email protected] |
| From: Eswar Ulluri, TekWissen_LLC [email protected] Reply to: [email protected] Overview: TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc. Title: Business Analyst Sr Work Location: Southfield, MI, 48075 Duration: 7 Months Job Type: Contract Work Type: Onsite Dept: 151420 Pay Rate: $55-$55/hr. Engagement Description: The Business Analyst Sr. will be responsible for leading processes and projects that ensure compliance oversight and ongoing monitoring of client Medicare Advantage and Part D programs. This positions responsibilities include developing monitoring review processes to ensure compliance with CMS regulations for Medicare Advantage operations. This role develops and improves workflows and business processes to strengthen controls, mitigate risks, and improve quality and efficiency. Interface with external customers, including regulatory agencies and professional associations, internal customers and vendors to identify and/or analyse business problems and develop solutions is required. RESPONSIBILITIES/TASKS: Develop and implement risk assessment and monitoring review processes to mitigate and/or remediate risk within the Medicare Advantage (MA) line of business Identify, analyse, and develop solutions to assist in the identification and mitigation of compliance risks and strengthen controls Track and manage corrective action plans to address identified compliance risks and deficiencies. Draft communications for executive leadership, CMS regulators, and internal departments Research, interpret, and understand CMS regulations and applicable laws Collect and review evidence from vendors (FDR) to support MA compliance requirements Chair and participate in focused project workgroups Interface with various departments, senior management, and individuals to provide expertise in compliance and regulatory issues and initiatives Represent leadership staff at meetings in their absence. May have supervisory responsibilities as required. Ensure expectations are developed, controlled, and executed in a timely manner. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. Top 3 Required Skills/Experience Experience with Medicare Advantage programs Knowledge of CMS regulations and related guidance Strong organizational skills with demonstrated attention to detail Required Skills/Experience The rest of the required skills/experience. Include: Compliance, regulatory, or auditing experience Excellent analytical, organizational, planning, and verbal and written communication skills. Ability to manage competing priorities Preferred Skills/Experience Optional but preferred skills/experience. Include: Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word). Ability to analyse, consolidate, and report information to internal and external stakeholders. Ability to work independently, within a team environment, and with multiple priorities. Education/Certifications Include: Bachelors degree in business or a related field. Relevant combination of education and experience may be considered in lieu of degree. Keywords: information technology Massachusetts Michigan |
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| Fri Oct 13 20:45:00 UTC 2023 |