Business Analyst, Senior, California

Your Role

The Installation and Billing department ensure accurate and timely member eligibility and premium billing. The Business Planning and Risk Management team enables goal setting and corporate strategy alignment, budget, forecasting, staffing, and performance monitoring to enable department success. Additionally, they enable quality assurance; drive adherence to standards, regulations and internal policies; mitigate risks and optimize operational efficiency to support organizational goals of compliance and audit readiness. The Business Analyst Senior will report to the Senior Manager, Program & Project management. In this role you will lead and manage Small Business and Individual Family Plan (IFP) compliance guidelines in consultation with Legal, Product, Sales, I&B, and other stakeholders.

 

Your Work

In this role, you will:

Provide complex analytical support through the analysis and interpretation of data in support of cross-functional business operations

Develop annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)

Develop, prepare, and analyze reports with complex analysis and data for management review, and present to various levels of management

Define business requirements and provide analysis to increase operational efficiency

Provide analytical support for multiple, complex cross-functional projects simultaneously; establish work plans and timelines

Manage Small Business and IFP compliance guidelines in consultation with Legal, Product, Sales, I&B, and other stakeholders 

Create training materials and conduct trainings

Actively participate in Small Business enrollment forms revision processes to improve workflows/processes and customer experience, implement mandates and business rule changes, facilitate automated enrollment, ensure compliance with regulations and business rules, and deter fraud and abuse

Identify & assist in the implementation of process improvements and automated enrollment business rule logic

Analyze, research, and consult with appropriate resources to provide guidance on compliance issues and questions and ensure policies, procedures, and communications meet state, federal, and business requirements. Proactively identify and mitigate potential risks that could impact quality or compliance to ensure audit readiness

Your Knowledge and Experience

Requires a bachelor’s degree or equivalent experience

Requires at least 5 years of prior relevant experience

Proficiency in Word, PowerPoint, and Excel desired

Experience in IFP and Small Group desired