Business Analyst IV – Claims Operations

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🔥 3 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Perform and lead analysis and interpretation to link business needs and objectives for the assigned function • Implement process improvements • Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing of various systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Resolve issues and identify opportunities for process redesign and improvement • Perform detailed analysis on multiple projects, recommend business solutions, and ensure successful implementations • Improve and revise business processes and requirements • Evaluate risks and concerns and communicate them to management • Coordinate with business units and departments to develop and deliver training programs • Develop, share, and incorporate organizational best practices into business applications • Oversee changes to departmental policies and procedures, including communicating and implementing changes • Serve as the subject matter expert on the assigned function product to ensure operational performance

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Advanced knowledge of healthcare claims operations and claims processing workflows highly preferred • Experience working with claims processing systems, including Amisys and Golden • Demonstrated experience identifying and implementing process improvements within claims operations • Advanced Excel skills strongly preferred • Ability to travel • Bachelor’s degree in related field or equivalent experience • 6+ years of business process or data analysis experience, preferably in healthcare, or 5+ years of HEDIS analysis • Advanced knowledge of Microsoft Applications, including Excel and Access preferred • Project management experience preferred

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation

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