Service Integration Analyst II

CareSource; Dayton (OH); On-site; USD 63,000 - 100,000; Full time

Job summary

CareSource in Dayton, OH is seeking a Service Process Analyst II to identify opportunities for improvement in Customer Care's business processes. You will collaborate with stakeholders to design and implement new procedures, audit processes, and act as SME for assigned markets/products.

You will analyze data, map processes, document SOPs, and support automation and call-volume reduction initiatives, while training new team members and contributing to reports for senior leadership.

Qualifications

• Requires a high school diploma; bachelor’s degree or equivalent experience preferred.
• Experience translating business requirements into technical specifications.
• Two years of healthcare payer customer service experience.
• Familiarity with Six Sigma, LEAN or APQC preferred.
• Proven ability to analyze data to support recommendations.

Responsibilities

• Manage three medium-complexity projects concurrently.
• Serve as SME for assigned markets/products, ensuring policy, process, and training compliance.
• Ensure seamless data integration and flow between systems.
• Perform data analysis and process mapping to identify inefficiencies and automation opportunities.
• Create SOPs and workflow diagrams to document processes.
• Collaborate with leaders to identify and prioritize improvement opportunities.

Skills

Interpersonal skills

Active listening

Critical thinking

Communication skills

MS Office

NICE CXOne

Healthcare payer knowledge

Education

High School Diploma

Bachelor’s degree or equivalent

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Visio

SharePoint

Dynamics 365

Job description

Job Summary

The Service Process Analyst II identifies opportunities for improvement in Customer Care's business processes and recommends projects aimed at enhancing quality, reducing costs, and promoting automation and call reduction. This position collaborates with stakeholders to ensure alignment and successful implementation of new procedures, conducts process audits and root cause analyses, and serves as a subject matter expert for assigned markets/products.

Essential Functions

• Manage a minimum of three medium complexity projects concurrently under limited direction of a manager
• Act as a Subject Matter Expert for assigned markets/products, ensuring that policies, processes, and training are compliant with contractual, regulatory, accreditation, and quality standards.
• Ensure seamless data integration and flow between systems.
• Perform comprehensive data analysis and process mapping to identify obstacles, inefficiencies, and opportunities for automation or reduction of inbound volume/AHT.
• Create comprehensive process documentation and guidelines, including standard operating procedures and workflow diagrams.
• Partner with leaders and subject matter experts across CareSource to identify and prioritize process improvement opportunities aligned with organizational strategic goals.
• Assess incoming service change requests and engage with stakeholders to discuss requirements and prioritize actions, ensuring optimal use of time and resources.
• Assist with audits, conversations with regulators, and cross-functional conversations requiring a Customer Care subject matter expert.
• Contribute content for Voice of the Customer report, Status Reports, and other communications to Senior Leadership.
• Train new team members to orient them to departmental policies, procedures, and responsibilities.
• Perform any other job-related instructions as requested.

Education and Experience

• High School Diploma is required
• Bachelor’s degree or equivalent years of relevant work experience is preferred
• Experience translating business requirements into technical specifications is required
• Experience and expertise with quality or process methodologies (i.e. Six Sigma, LEAN, APQC, etc.) is preferred
• Proven experience in utilizing data to inform and support recommendations is required
• A minimum of two (2) years of customer service experience related to healthcare payer dealing with both members and providers is required

Competencies, Knowledge and Skills

• Demonstrates a high level of accountability as it relates to ensuring Customer Care has all required processes and tools.
• Proficient use of Microsoft products including Word, Excel, PowerPoint, Visio, SharePoint, and Dynamics 365 is required.
• Experience with NICE CXOne is preferred.
• Strong interpersonal, active listening and critical thinking skills
• Ability to document and maintain system requirements including process flows is required
• Ability to keep current on business processes/technologies through self-directed learning
• Excellent written and verbal communication skills
• Ability to develop, prioritize and accomplish goals

Licensure and Certification

Six Sigma Green Belt and APQC Certification is preferred

Working Conditions

General office environment; may be required to sit or stand for extended periods of time

Hybrid Position; 2-3 days/week in Dayton office if home address is within 45 miles.

Preferred days are Tuesday, Wednesday, & Thursday.

Ability to travel as required by the needs of the business.

Compensation Range

$62,700.00 - $100,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.

In addition to base compensation, you may qualify for a bonus tied to company and individual performance.

We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary): Salary

Organization Level Competencies

Fostering a Collaborative Workplace Culture

Cultivate Partnerships

Develop Self and Others

Drive Execution

Influence Others

Pursue Personal Excellence

Understand the Business

Equal Opportunity Statement

CareSource is an Equal Opportunity Employer.

We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Company Mission

The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.