Senior Healthcare Ops Analyst — Process & ROI

CareSource; Michigan; On-site; USD 94,000 - 165,000; Full time

Job summary

CareSource is seeking an Operations Business Analyst IV in Michigan to drive operational excellence. You will oversee business analysis initiatives, lead cross-functional process improvements, and align solutions with organizational strategy.

The role includes working with claims adjudication processes and interfacing with stakeholders and leadership. Ideal candidates have 7+ years in health care operations, strong analytical and communication skills, and experience with regulatory reporting.

Qualifications

• Bachelor’s degree in business administration, healthcare management, or related field.
• 7+ years of health care operations experience in insurance or managed care.

Responsibilities

• Define and implement best practices for business analysis aligned with enterprise architecture.
• Lead end-to-end process redesigns including feasibility studies and ROI assessments.
• Develop operational readiness frameworks for new systems and processes.
• Serve as liaison between stakeholders, technical teams, and leadership.
• Manage policy and performance of claim lifecycle and implementation activities.
• Advise leadership on change management aligned with objectives and regulatory requirements.
• Perform cost-benefit and ROI analyses and support business case development.
• Support strategic planning and feasibility studies for goals and objectives.
• Identify scope and expected benefits across initiatives and process improvements.
• Lead reviews of reports and data to identify patterns and provide summaries.
• Develop testing/validation and mentor junior analysts.

Skills

Regulatory reporting

Stakeholder management

Analytical thinking

Multi-tasking

Communication skills

Leadership

Critical thinking

Customer service

Time management

Decision making

Education

Bachelor’s degree in business administration / healthcare management or related field

Job description

CareSource is seeking an Operations Business Analyst IV in Michigan to drive operational excellence. You will oversee business analysis initiatives, lead cross-functional process improvements, and align solutions with organizational strategy.

The role includes working with claims adjudication processes and interfacing with stakeholders and leadership. Ideal candidates have 7+ years in health care operations, strong analytical and communication skills, and experience with regulatory reporting.