Virginia Premier Health Plan Operations Analyst II in Glen Allen, Virginia

About Us

Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.

By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.

At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.

If this sounds like you, read on!

Overview

The Operations Analyst is responsible for the data analysis, process engineering, report development and generation for the Member Operations department. This position is responsible for developing an extensive expertise in the IDX Managed Care Application (MCA), QNXT and all interface applications, both customized and packaged.

An Operations Analyst II may be the primary contact for one or more system interface applications and is expected to provide a high level of expertise with matters relating to this interface and its functionality.

Responsibilities

  • Develop and analyzes business performance reports for transportation, call center and enrollment data; provides notations of performance deviations and anomalies

  • Perform monthly enrollment process

  • Perform complex data analysis and report writing to identify trends

  • Create complex queries. Apply extensive understanding of database tables, relations, data types and values

  • Develop an expertise in GE MCA report functionality, including DBMS, UM, and other standard report systems

  • Initiate process improvement and automation from concept to implementation

  • Document applications for use in training, maintenance, and department procedures

  • Research, gather and document requirements for adhoc reporting, project initiatives for new vendor, or business development opportunities.

  • Monitor, test and support system changes for applications

  • Develop advanced knowledge in referral module and interface with transportation scheduling/dispatch system

  • Create and modify transportation requests entered into transportation scheduling/dispatch system

  • Analyze issues related to transportation reimbursement process and makerecommendations to management for resolutions.

  • Build advanced reports and filters using call center reporting software

  • Ensure programs and business processes meet necessary requirements and are accurately captured in Process Maps and SOPs.

  • Attend meetings, compiles and publishes meeting minutes along with deliverables and other requirements.

  • Confidently works with all levels within the organization to accomplish project goals

  • Performs other duties as assigned

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Bachelor’s degree in Business, Mathematics, Economics, Information Systems or related technical field

  • Lean Six Sigma certification preferred

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Proficient knowledge of SQL queries to include ability to create and populate databases, perform data normalization, create query analysis, conduct table indexing, perform multiple joins, and comfortable use of functions (average, count, sum, etc.)

  • Healthcare with Medicare and/or Medicaid Operations preferred

  • Strong quantitative, analytical, organizational and problem solving skills

  • Experience in health insurance claims processing, operational and/or data analysis experience; knowledge in database structures and standard query and reporting tools

  • Proficient in statistical use of Microsoft Excel, to include comfortably utilizing functions, developing charts and graphs, inserting formulas, performing Lookups, sorting and filtering data

  • Proficient in Microsoft Access, to include ability to create customs forms, create reports, create lookup and parameters, and utilize function/expression building

  • Proficient knowledge of flow charting/process mapping

  • Experience in process management and process optimization preferred

WORK BACKGROUND/EXPERIENCE

  • A minimum of one year related experience

  • One or more years’ experience as a data, systems or business analyst

  • One or more years business or Healthcare related experience

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

Our mission is to inspire healthy living within the communities we serve!

Job ID 2018-5378

As an equal opportunity employer, Virginia Premier is committed to a diverse workforce. To ensure non-discrimination and affirmative action for individuals protected by Executive Order 11246, as amended, Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Veterans’ Readjustment Act of 1974, as amended, and Title I of the Americans with Disabilities Act of 1990, as amended, Virginia Premier will consider applicants for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Applicants who require accommodation in the job application process may contact Recruitment at 804-819-5151 for assistance. It is the policy of Virginia Premier Health Plan, Inc., to comply with the requirements of the Drug-Free Workplace Act of 1988. It is a violation of our drug-free workplace policy to use, possess, sell, trade, and/or offer for sale alcohol, illegal drugs or intoxicants in our workplace. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. Virginia Premier participates in E-verify.