Service Integration Analyst II

CareSource; Kentucky; Hybrid; USD 63,000 - 100,000; Full time

Job summary

CareSource is seeking a Service Process Analyst II to identify opportunities for improving Customer Care processes, drive projects, and ensure alignment with stakeholders. You will perform process audits, root cause analyses, and develop systems-based solutions that reduce costs and improve quality.

The role requires translating business needs into technical specs, leveraging Six Sigma/LEAN methods, and collaborating across CareSource markets.

Qualifications

• Bachelor’s degree or equivalent years of relevant work experience.
• Two+ years of healthcare payer customer service experience.
• Experience translating business requirements into technical specifications.
• Familiarity with Six Sigma, LEAN, or APQC methodologies preferred.
• Proven ability to analyze data and support recommendations.
• Strong ability to document and maintain system requirements including process flows.

Responsibilities

• 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 processes and training meet standards.
• Perform data analysis and process mapping to identify obstacles and opportunities for automation or volume reduction.
• Create comprehensive process documentation and SOPs.
• Collaborate with leaders to identify and prioritize improvement opportunities aligned with goals.
• Assist with audits and regulatory conversations requiring a CareSource subject matter expert.

Skills

Process improvement

Data analysis

Root cause analysis

Project management

Stakeholder collaboration

Education

Bachelor’s degree or equivalent

Six Sigma Green Belt

APQC Certification

Tools

MS Office (Word, Excel, PowerPoint)

Visio

SharePoint

Dynamics 365

NICE CXOne

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.

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.

$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.

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

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.