Senior Health Plan Analyst – Enrollment & Billing

CalOptima Health Partnership; California; On-site; USD 78,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits

CalPERS pension

PTO

Flexible scheduling

Job summary

CalOptima Health is seeking a Senior Business Analyst for the Covered California initiative to analyze enrollment and premium billing functions. You will translate requirements, support cross-functional teams, and ensure regulatory compliance in a fast-paced environment.

Role involves design sessions, testing, documentation, and driving data-driven improvements across Operations, IT and Finance. Office-based with potential telework within California.

Qualifications

• Bachelor's degree in business, healthcare administration, finance, information systems or related field required.
• Experience in reporting and data analysis required.
• 3 years of experience supporting system implementations or operational process improvement in health care operations, enrollment, billing, finance or business analysis.

Responsibilities

• Analyze Covered California enrollment and premium billing processes; develop and implement improvements.
• Translate business requirements into functional specifications and test scenarios.
• Coordinate with Operations, IT, Finance and Compliance to ensure regulatory alignment and successful implementations.
• Develop reports and dashboards to support operational decision-making and UAT coordination.

Skills

Business analysis

Data analysis

Reporting

Stakeholder collaboration

Education

Bachelor's degree in business, healthcare administration, finance, information systems or related field

Tools

Jira/Confluence

ServiceNow

Smartsheet

MS Project

Job description

CalOptima Health is seeking a Senior Business Analyst for the Covered California initiative to analyze enrollment and premium billing functions. You will translate requirements, support cross-functional teams, and ensure regulatory compliance in a fast-paced environment.

Role involves design sessions, testing, documentation, and driving data-driven improvements across Operations, IT and Finance. Office-based with potential telework within California.