Business Analyst III Managed Care Operations

Dignity Health; Bakersfield (CA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare organization is seeking a Business Analyst III to support their Managed Care Operations team. This remote role involves analyzing and improving operational processes, ensuring data integrity, and developing advanced reporting tools. Candidates should have over 5 years of experience in business analysis within managed care and possess a bachelor's degree. Strong skills in data analysis tools like SQL, PowerBI, and Excel are required. The compensation ranges from $39.18 to $58.28 per hour.

Qualifications

• 5+ years of experience in business analysis within managed care operations.
• Demonstrated ability to communicate complex findings to stakeholders.
• Familiarity with HIPAA regulations and data governance best practices.

Responsibilities

• Lead analysis and evaluation of data related to Managed Care Operations.
• Oversee improvements across credentialing, contracting, provider relations.
• Manage complex projects to drive operational efficiency improvements.

Skills

Data analysis

Stakeholder management

Project management

Problem-solving

Data-driven strategy development

Education

Bachelor's degree in relevant field

Master's degree (preferred)

Tools

SQL

PowerBI

Excel

Job description

Job Summary and Responsibilities

This position is remote but will be expected to work PST business hours.

Position Summary:

The Business Analyst (BA) III will serve as the internal consultant for the Managed Care Operations team, providing analysis, reporting, and operational support across a variety of functions, including credentialing, contracting, claims, provider relations, quality/risk, care coordination, utilization management, and business development. They will bridge the gap between operational needs and technology solutions, ensuring data integrity and actionable insights for key stakeholders. As part of the BA Hub, these roles will also partner closely with the Population Health Analytics function to ensure consistent and accurate reporting across all markets.

Responsibilities may include:

• Lead the analysis and evaluation of data, processes, and systems related to Managed Care Operations, ensuring they align with strategic business goals.
• Oversee and drive improvements across multiple functional areas, including credentialing, contracting, provider relations, and care coordination.
• Serve as the lead SME for the Managed Care Operations Hub, ensuring the integration of operational needs with data governance, analytics, and reporting.
• Develop comprehensive business cases for process improvements, including cost, service, and benefit dimensions.
• Manage and coordinate complex projects, ensuring alignment across teams and providing recommendations to leadership for operational efficiency improvements.
• Conduct high-level analysis to identify emerging trends and opportunities for improvement within Managed Care Operations.
• Lead the creation and execution of advanced reporting and dashboard tools to track KPIs and drive continuous operational improvements.
• Partner with Population Health Analytics to ensure the alignment of data analytics and managed care reporting across markets.

Job Requirements

Minimum Qualifications:

• 5+ years of experience in business analysis within managed care operations, including hands-on experience in one or more of the following areas: contracting, claims management, UM or care coordination.
• Bachelor's degree or 5 years of equivalent work experience in any of the following environments; healthcare administration, managed care business, information technology, or related fields.
• Advanced proficiency in data analysis tools (e.g., SQL, PowerBI, Excel).
• Proven track record of leading complex projects, developing data-driven strategies, and driving operational efficiency.
• Strong experience in stakeholder management, reporting, and performance monitoring within managed care environments.
• Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify key trends.
• Ability to effectively communicate with stakeholders at all levels, translating technical findings into actionable business insights.
• Demonstrated ability to collaborate across functions to deliver operational improvements and strategic initiatives.
• Familiarity with HIPAA regulations and data governance best practices.

Preferred Qualifications:

• Masters' degree in computer science, mathematics, management information systems, or a closely related field preferred.
• Experience in leading cross-functional teams within managed care operations, with a focus on strategic project management and process optimization preferred.
• Advanced knowledge of data governance, data integration, and reporting systems within the context of managed care preferred.
• Strong familiarity with healthcare data standards (e.g., HIPAA compliance, EDI transactions, 837/834 files), and managed care systems (e.g., EZCAP, Qnxt, ImageNet) preferred.
• Proven ability to translate business needs into technical solutions, working closely with IT teams to drive system improvements and enhance optional performance preferred.

We are an equal opportunity/affirmative action employer.

Pay Range

$39.18 - $58.28 /hour