Healthfirst Operations Analyst in Lake Mary, Florida
The Operations Analyst (OA) is responsible for tracking, reporting, analyzing and summarizing operations data. The OA position assists with the maintenance and testing of all system related changes; including workflows, validations, and automated processes. The OA runs and reconciles reports. The OA owns the accuracy and timeliness of reported data as well as communication and resolution of identified issues involving reports and trends.
Duties & Responsibilities:
Complete daily, weekly and monthly analysis, reports, summaries and dashboards
Receive and respond to inquiries and complaints and interface with internal and external personnel
Support audit, compliance and regulatory responsibilities
Meet SLA guidelines in creating files, reconciling information, executing system batches, etc.
Analyze business processes, identify root causes and provide data-based insights and recommendations for process improvements
Access and analyze data across multiple systems to identify areas of risk, complete root cause analysis to determine key drivers and develop recommendations to mitigate; report findings and recommendations to management.
Participate in systems testing and validation for various operations systems
Work directly with other teams or business units as a subject matter expert to understand objectives and codependences to ensure consistency
Write, maintain and execute basic and complex data queries to generate required data sets. Maintain and execute routine queries
Additional duties as assigned
High School Diploma or GED from an accredited institution
Experience with one or more of the following: querying data using data tables and ACCESS, identifying risks, issues and providing resolution options
Experience working in Microsoft product suite, including Outlook, Word, PowerPoint and Excel
Manipulation and creation of Excel spreadsheets; including but not limited to standardizing reports across multiple sheets, utilizing vLookups and functions/formulas, creating, using and interpreting pivot tables, filtering and formatting to generate desired results
Bachelor's Degree from an accredited institution
Work experience in health insurance or healthcare environment
Knowledge of MHS and CRM systems
Working experience with Medicare/ Medicaid programs, regulations and reimbursement
Working experience with NYSoH or Federal Exchange
Ability to demonstrate effective verbal and written communication
Compliance & Regulatory Responsibilities: See Above
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 1-212-801-6000. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement at https://www1.eeoc.gov/employers/poster.cfm
Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.
Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:
Dream Big, Plan Wisely
Break Down the Walls
Think Critically, Speak Up, Deliver with Pride
Inspire Through Trust, Lead By Example