Senior Business Analyst, Government Programs Operations Claims & Encounters
$135k - $146kCapital Rx
Hybrid (Local to New York, NY, Denver, CO or Charlotte, NC) Position Summary The Business Analyst provides support gathering and documenting business and reporting requirements that align with state and federal guidelines. This individual will analyze complex problems and issues using available information from both internal and external sources. Other responsibilities will include creating specifications documents for business processes, reports, data extracts, and analyses based on business needs. Identify and interpret trends in datasets to find possible outliers or patterns that can be used to drive process improvements. Collaborates with internal and external cross‑functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, clinical operations) to design, refine, automate, and maintain operational capabilities. Position Responsibilities Monitors for changes in existing business processes and updates documentation accordingly – Finds new opportunities for process developments and improvements Intake, analyze and manage requests from stakeholders Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team Drives root‑cause analysis and resolution of data and processes issues/errors by partnering with key stakeholders Supports analytical, problem‑solving functions by defining and documenting specifications pertinent to all departmental processes Analyzes business workflow and system needs for conversions and migrations to ensure that government submissions, recovery, and cost savings regulations are met Prepares end user documentation and training materials as needed Supports government data submission processes by analyzing complex data issues using data from internal and external sources Improves government data submission processes by reviewing and synthesizing state and federal resources, consolidating into comprehensive business requirements documents Supports creation of intake request to enhance existing processes by gathering requirements and level setting with stakeholders on required processes Develops and sets up performance metrics for stakeholder distribution Performs root cause analysis of government data processing and submission issues; develops recommendations based on data and industry knowledge Minimum Qualifications 3+ years of healthcare experience 3+ years of business process analysis, preferably in healthcare 3+ years of experience with Government Exchange programs Demonstrable knowledge of SQL, Excel, and flow‑charting tools Experience with implementation/project management Experience working with cross‑functional teams Extremely flexible, highly organized, excellent communication and able to shift priorities easily Attention to detail & commitment to delivering high‑quality work product Comfort or experience in a fast‑paced, growing environment Intellectual and professional curiosity Familiarity with the agile framework/Certified Scrum Product Owner preferred Bachelor's degree in Business Administration, Data Analytics, Computer Science or 3+ years of relevant experience Compensation New York, NY: $135,000 – $146,000 USD Denver, CO: $125,000 – $135,000 USD Charlotte, NC: $115,000 – $125,000 USD EEO Statement All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non‑compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Capital Rx
- Capital Rx is seeking a Senior Manager for Government Programs Operations to oversee operational compliance with federal and state regulatory requirements. The role requires leading regulatory reporting, claims operations, and audit readiness, ensuring quality performance...OperationsSeniorClaims
- Judi Health is looking for a Senior Manager, Government Programs Operations to manage regulatory compliance and operational oversight. Located in Charlotte, NC, this role requires strong leadership and experience with Exchange programs to ensure timely, accurate reporting...OperationsSenior
$87k - $109k
...Platform (EHP), which consolidates all claim administration-related workflows in... ...Charlotte, NC) Position Summary The Government Programs Operations Specialist (MPPP) provides operational... ...functionality and ensure outcomes meet business requirements. Support quality...OperationsClaimsLocal area$76k - $95k
...), which consolidates all claim administration-related workflows... ...Position Summary The Government Programs Analysis & Efficiencies Analyst will play a role in supporting the operational success of Medicare,... ...regulatory requirements and business objectives. Position Responsibilities...OperationsClaimsLocal areaFlexible hoursShift work$78.4k - $98k
...EHP), which consolidates all claim administration-related... ..., NC area) Position Summary Business Analysts are responsible for collaborating... ...team enables Judi Health's operational and clinical teams to be more... ...operational tasks, empower clinical programs that drive down costs for...OperationsClaimsWork experience placementLocal areaFlexible hours- ...Senior Discovery Business and System Analyst Employment Type: Full-Time, Executive... ...to solve the government’s most dynamic problems... ...analysis of operational business requirements... ...solution providers that claim to satisfy the... ...can be used by the Program Management Office...SeniorClaimsFull timeFor contractorsWork at officeFlexible hours
- ...Management division to ensure alignment between business needs and delivered capabilities. Elicit... ...design, implementation, and technology operations, leveraging our core engineering... ...modernize technology, and deliver complex programs with a product engineering approach. Our...OperationsSeniorVisa sponsorshipFlexible hours
- ...subcontractor schedule impacts and or claims of productivity impacts.... ...the overall site safety program as required and ensuring subcontractor... ...a coordinated project operation. Resolve local area problems,... ...of those an employee encounters while performing the essential...OperationsSeniorClaimsPermanent employmentContract workTemporary workFor contractorsFor subcontractorWork at officeLocal area
$81.7k - $112.3k
...million individual, small business and institutional clients.... ...Financial is looking to add a Senior Business Analyst to their Conversion team!... ...gathering, writing and alignment, program engagement and team... ...to identify root cause of operational and service issues. Implement...OperationsSeniorFull timeH1bWork at officeWork from homeVisa sponsorship1 day per week$89.01k - $108.79k
...BM revenue, profitable new business in the Workforce Benefits market... ...seeking a talented Senior Business Analyst to join our Workforce Benefits... ...Analyst in our Strategy & Program Management Office (PMO), you... ...understanding of business operations, processes, and process mapping...OperationsSeniorWork at officeRemote work- .../Overview We are currently seeking a Senior Business Analyst - SAP S4/Hana Sales & Distribution to... ...business needs and objectives, current operational procedures, problems, input and... ...technical reports to learn ways to develop programs that meet user requirements....OperationsSenior
- Senior Business Analyst - SAP S4/Hana Sales & Distribution We are currently seeking an experienced... ...needs and objectives, current operational procedures, problems, input and output... ...technical reports to learn ways to develop programs that meet user requirements....OperationsSenior
- ...of factors affecting business efficiency, and aids strategic... .... Responsibilities Operational Support - Provides... ...lower level business analysts and leading workflow.... ...a focus on accuracy, governance, and scalability Benefits... ...and quality benefits program to meet the needs of...OperationsSeniorWork at office
- ...The Business Analyst, Pricing and Underwriting , is responsible... ...to inform daily operations and executive... ...Analyze pharmacy claims, drug pricing, rebate... ...analytical support to senior management for strategic... ...or other applicable programming language (Python/VBA/...OperationsClaimsFull timeTemporary workWork at officeRemote workWork from home
- Senior Business Analyst - Capital Markets Job Level: Director Location: Charlotte, NC, US, 28202... ...extensive global network. The Group’s operating companies in the Americas include Sumitomo... ...migrations, or transformation programs. Proven ability to work in Agile, hybrid...OperationsSeniorFull timeWork at officeLocal areaWork from homeWorldwide
- ...a job opening for the position of Senior Operations Performance Analyst based in Charlotte, NC. Responsibilities... ...spreadsheet models that streamline business processes, promote operational... ...of views to business stakeholders; Programming languages including Python, VBA, or...OperationsSeniorWork at office
$69.3k - $126k
...Attributions Performance Analyst to join our Investment Operations team. In this... ...to support new business and operational... ...team’s GIPS claim of compliance... ..., including senior operations, client... ...in a bonus program. Sales positions... ...consult relevant government resources....OperationsClaimsHourly payTemporary workWork experience placementH1bWork at officeRemote workFlexible hours- Senior Business Systems Analyst (BSA) Dole Fresh Fruit Company is seeking a dynamic Senior Business Systems... ...Microsoft Dynamics 365 Finance & Operations (F&O) and Salesforce platforms. Responsibilities... ...contribute to larger projects under program managers. Track and manage project...OperationsSeniorFull time
$105k - $120k
...safer hospitals, safer businesses, and ultimately,... ...systems for Government & Public Safety Communications... ...(MSI) is seeking a Senior Project Management Analyst to support the... ...Force Sustainment Programs. This critical role... ...Service and Upgrade Operations (UO) transactional...OperationsSeniorContract workRemote workRelocation- ...Note : This is an educational program, not a job. Successful completion of the program... ...specialist processes and codes healthcare claims to ensure accurate billing and insurance... ...reimbursement, supporting the financial operations of healthcare facilities. Highlights...OperationsClaims
$87.2k - $109k
...consolidates all claim administration‑related... ...Management Analyst will be responsible... ...the day‑to‑day operational tasks related to... ...applicability and business impact Summarize... ...processes, tools, and governance frameworks Drive... ..., government programs, compliance, or regulatory...OperationsClaimsLocal areaFlexible hours$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote... ...Opportunities: Use claim data analysis to... ...with SIU, claims operations, and policy teams... ...'s degree in Business, Healthcare, Data... ...wellness and well-being programs. What You Can... .../or level of US government security...OperationsSeniorClaimsLocal areaRemote work- ...EisnerAmper is seeking a Senior Consultant - Grants Management in our Government Services practice. This... ..., IHS, IIJA, and DHHS programs Prepare client... ...Bachelor's degree in Business, Accounting, Finance, Public... ...range of funding sources, operational challenges and...OperationsSeniorWork at officeLocal areaRemote work2 days per week
$52k - $65k
...Category: Fixed Base Operations (FBO) Career Level: Professional... ...Charter, Completions, Government Services, FBO, Fixed... ...Position Summary The Senior Manager Line Service... ...of those an employee encounters while performing the... ..., employee assistance programs, health and wellness...OperationsSeniorTemporary workWork experience placementWorldwideFlexible hoursShift work- ..., designing wellbeing programs, or advising on workforce... ...meaningful change for businesses and the people who... .... Overview As the Senior Client Manager you will... ...client service and/or claims management experience... ...an undue hardship on the operation of our business....OperationsSeniorClaimsFull timeLive outWork at officeLocal areaFlexible hours
- ...will own day-to-day HR operations while partnering with... ...structured onboarding programs and new-hire orientation... ...success of the business. Participate in leadership... ...workers’ compensation claims, and safety documentation... ...work effectively with senior leadership. Working...OperationsSeniorClaimsInternshipSummer internshipWork at office
- ...we believe that when businesses are protected, they’re... ..., we’re looking for a Senior Client Service Manager... ...gaps in coverage, review claims, secure existing... ...job function) Training programs Gallagher Thrive program... ...undue hardship on the operation of our business. #J-18...OperationsSeniorClaimsLive outWork at officeLocal areaFlexible hoursShift work
- ...in Financial Services & Insurance Senior Business Analyst PRIMARY PURPOSE : The Sr Business... ...resource for business workflows and operational processes Performs other duties as... ...delivery required. Experience in claims, insurance, healthcare, or other regulated...SeniorClaimsLocal area
$81.7k - $135k
...Lookback Review COE - Senior Will you shape the... ...implement strategies, operating models, and compliance... ...mentors and training programs. Your key responsibilities... ...Research our clients’ business operations and... ...and use tax refund claims Participation on a...OperationsSeniorClaimsSummer holidayImmediate startFlexible hours$80.9k - $160.3k
...Crowe is seeking a talented and driven Senior Business Analyst / Product Owner to join our Product... ...epics for decomposition and partner with Program Leadership and teams to ensure... ...with cross‑functional teams, including operations, to identify, prioritize, and drive resolution...OperationsSeniorLocal areaWorldwide
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