Resource Operations Analyst II

Job Summary:

The Resource Operations Analyst conducts Service Operations business analysis function to include analysis and interpretation of statistics.

Essential Functions:

• Provide tracking and reporting of results in adherence to daily processes and/or financial performance of assigned vendor(s)
• Design, gather and analyze data for various function areas for resources, utilization, process and productivity performance and make recommendations for improvement
• Ensure Service Operations processes and reporting are in place to meet accreditations and regulatory requirements
• Collaborate in the development of business systems to support Service Operations related business processes and core organizational functions
• Prepare and deliver reports, recommendations, or alternatives that address trouble areas in systems or processes for Service Operations
• Establish application strategies and partner to drive application improvements
• Collaborate with business partners and end users to define business, financial, and operations requirements and systems goals
• Lead support activities including problem analysis, technical evaluation, work estimates, and implementation services
• Direct and train new team members to orient them to policies, procedures, and responsibilities
• Perform any other job related instructions as requested

Education and Experience:

• High School Diploma is required
• Bachelor of Science degree in Management Information Systems, Business Analysis, or equivalent work experience is preferred
• A minimum of two (2) years of customer service experience related to healthcare payer dealing with both members and providers is required
• One (1) or more years project management experience is required, to include previous experience implementing external partner operations and creation of process maps and policies
• Experience translating business requirements into technical specifications is required
• One (1) or more years of experience supporting multiple state jurisdictions with different regulatory and service requirements is preferred

Competencies, Knowledge and Skills:

• Overall knowledge and understanding of government regulatory requirements
• Experience with SAS and SharePoint is preferred
• Knowledge of application development, system design and development tools and languages
• Proficiency in Microsoft Office is required
• In depth knowledge of Medicaid/Medicare regulatory requirements
• Ability to document and maintain system requirements including process flows is required
• Ability to analyze processes and produce recommendations for improvements is required
• Ability to develop, prioritize and accomplish goals
• Ability to keep current on technologies through self-directed learning
• Excellent written and verbal communication skills
• Strong interpersonal, active listening and critical thinking skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for long periods of time
• Ability to travel as required by the needs of the business

Compensation Range:
$61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

Competencies:
- Create an Inclusive Environment
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.