Offers “Dxc Technology”

Expires soon Dxc Technology

Research and Policy Business Analyst

  • Madison (Dane)

Job description


·  Job Description:

Summary

Working onsite with the state of WI client in the Managed Care section. This position assists in oversight of the contract monitoring for HMOs. Gets requests from providers, HMOs or Members, works on quality improvement initiatives, looks at how services are provided to Members, and does research on issues or impacts. 

Experience: research, policy analysis, documenting and writing papers, project timelines and planning, dealing with conflict resolution.

The qualified candidate must have:

·  Strong research skills, including the ability to
·  Locate, review, and synthesize key historical project documentation.
·  Identify and interview subject matter experts to gather key information.
·  Research legal considerations and navigate statutes/regulations.
·  Research operational considerations and IS considerations.
·  Critically review and synthesis background information from a variety of sources.
·  Strong BA skills, including the ability to
·  Develop and validate business requirements.
·  Review and validate functional requirements.
·  Document as-is (current state) processes/workflows using process flow diagrams.
·  Develop to-be (future state) processes/workflows using process flow diagrams.
·  Strong analytical skills, including the ability to
·  Analyze data.
·  Create, merge, scrub, and manipulate data extracts.
·  Interpret/document data models.
·  Extensively use Microsoft Excel.
·  Strong communication skills, including the ability to
·  Write clear, concise, and accurate research papers.
·  Give clear and concise presentations.
·  Strong interpersonal skills, including the ability to
·  Work with internal and external stakeholders with a variety of backgrounds and areas of expertise, such as other analysts, attorneys, clinicians, IT professionals, communications staff, etc.
·  A knowledge of project management principles, processes, and tools.

Ideally, the candidate will have:

Knowledge of the healthcare industry, including a general knowledge of

·  The different types of healthcare providers.
·  How healthcare providers and facilities are licensed/credentialed.
·  The common business structures used in the healthcare industry.
·  The major healthcare providers and major integrated health systems in Wisconsin.
·  The major provider associations in Wisconsin.
·  The major healthcare payers (commercial, Medicare, Medicaid, etc.).
·  ·Knowledge of the healthcare billing process, including a general knowledge of claims submission, processing, and payment.
·  ·Knowledge of nationally-standardized medical code sets, including Current Procedural Terminology (CPT) codes, Health Care Procedure Coding System (HCPCS) codes, and International Classification of Diseases (ICD) codes.
·  ·Knowledge of medical terminology and conditions

Education and Experience Required:

·  Typically a Bachelor's degree in a technical or business discipline or equivalent experience.
·  Minimum of 2 years of related experience or a Master's degree and up to two years of experience.

Knowledge and Skills:

·  2 or more years experience.
·  Essential: requirements determination using structured techniques for documentation, analysis, evaluation/ validation; decomposition of high- level information into details; abstracting low- level information; distinguishing requests vs needs; distinguishing requirements vs. solutions; classifying/ prioritizing requirements; requirements change management and traceability; identifying risks; applying creativity to solving complex problems; building relationships and working collaboratively; effective verbal/ written communication; experience in an industry domain.
·  Specialized: developing structured user manuals and training; business rules modeling; develop and executing acceptance test plans.

Work Environment

·  Office environment

Make every future a success.
  • Job directory
  • Business directory