Systems Analyst

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: Job Summary: The Operation Analyst position provides support regarding standard procedures and best practices to meet business objectives. Responsible for the design, development, implementation and support of reports and/or extracts. Working with Business Leaders, subject matter experts and vendors to gather and document reporting requirements to meet business needs. Plans and executes independent, objective internal audits designed to test and confirm compliance with applicable State and Federal laws. Analyzes and understands regulatory requirements and applies identified requirements to business operations when developing and conducting compliance reviews. Monitors the progress, up to the remediation, of all deficiencies once identified. This position requires in-depth knowledge and understanding of claims processing functions. Ability to analyze and interpret fee schedules, contracts and network data entry for opportunities for data clean-up projects. This position works with multiple payers/clients as the liaison for claims issues and all other communication, Create and analyze system QA reports to ensure the integrity of the data entered into multiple systems. Supports the fulfillment of internal/external audits as required. Performs other job-related duties and projects as assigned. Benefit Highlights: Loan Forgiveness Program Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan SoFi Student Loan Refinancing Program Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: benefits.uhsguest.com About Universal Health Services: One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Qualifications Qualifications & Requirements: High school or equivalent required. Associate degree preferred 5 years health plan operations experience or health services experience preferred Good organization skills with ability to prioritize multiple activities in a rapidly changing environment Excellent interpersonal, communication and organizational skills with the ability to interact with all levels of personnel within the organization. Ability to understand from a systems level perspective the interdependence of one unit or system upon another, and how changes in any one part affect all others. Demonstrated ability and professional concern for bringing together knowledge of operations and information needs of users. In-depth knowledge and understanding on claims processing functions Ability to analyze, interpret and configure annual, quarterly and monthly fee schedules, contracts and ongoing maintenance. Ability to effectively communicate in English, both verbally and in writing. Excellent computer skills. Self-starter, Resourceful and able to execute projects in a fluid and fast paced environment Good organization, management, and reporting skills Attention to detail Strong knowledge and experience with MS Office, MS Project, MS Visio with the ability to use these and other tools to provide meaningful analytics Ability to effectively contribute as a team member or on individual assignments. Must be able to work independent, providing management with status updates Excellent analytical and problem-solving skills. Strong customer service focus Knowledge of operational processes within the Health Plan. Strong negotiation and persuasion skills. Excellent written and verbal communication skills. Ability to interact with all levels of personnel. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. #J-18808-Ljbffr Aiken Regional Medical Centers