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Corporate Functions & Operations WellCare - Business Analyst Careers

Clinical Business Analyst Job

Full Job Title: Clinical Business Analyst

Job Number: 1803769

Location: Tampa, FL

Date Posted: 2018-06-19

Works collaboratively with various levels of clinical staff and Information Systems staff to clarify needs, prioritize requests, and recommend workflow enhancements. Responsible for evaluating and documenting clinical processes, including step actions and workflows to construct and enhance the clinical model of care.

Reports to: Manager, Clinical Systems

Department: Population Health Solutions

Position Location: Tampa, FL 33634

Essential Functions:

  • Serves as a clinical resource for an assigned work stream unit - Intake, UM, CM, DM, Reporting or Appeals.
  • Assists in the documentation and gathering of detailed requirements and workflow processes and analysis.
  • Reviews current workflow and lead recommendations and defines requirements to build processes and forms needed to support the business in the new system.
  • Recommends and implements software based on best practices.
  • Analyzes customer needs and identify system and procedural solutions to enhance the clinical practices.
  • Identifies opportunities to leverage technologies in areas that improve and promote the clinical agenda.
  • Performs gap analysis.
  • Identifies needed process changes to ensure compliance with the use of technology to optimize care delivery processes and effectively communicate patient care activities.
  • Performs application testing and creates test scripts – SIT/UAT.
  • Develops and creates test plans for SIT and UAT.
  • Performs UAT Testing.
  • Works with IT to resolve update issues.
  • Communicates with internal partners to obtain sign-offs.
  • Ensures updates are tested and applied on a timely basis.
  • Provides documentation and training as needed.
  • Insures technology meets Compliance and Regulatory Requirements.
  • Performs other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in a related field, preferably health sciences
    • Required or equivalent work experience 5 years of relevant work experience required without Bachelors degree
    Candidate Experience:
    • Required 3 years of experience in a managed care organization using clinical skills
    • Required Other system implementation experience
    • Preferred 1 year of experience in Utilization Management and/or Care Management
    Candidate Skills:
    • Intermediate Demonstrated written communication skills
    • Intermediate Demonstrated interpersonal/verbal communication skills
    • Intermediate Ability to effectively present information and respond to questions from peers and management
    • Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
    • Intermediate Ability to work as part of a team
    • Intermediate Ability to work independently
    • Intermediate Ability to work in a fast paced environment with changing priorities
    • Intermediate Demonstrated organizational skills
    • Intermediate Other Ability to remain calm under pressure
    • Intermediate Other Ability to work overtime as required
    Licenses and Certifications:
    A license in one of the following is required:
    • Required Other LPN or RN
    Technical Skills:
    • Required Intermediate Microsoft Outlook
    • Required Intermediate Microsoft Word
    • Required Intermediate Microsoft PowerPoint
    • Required Advanced Microsoft Excel
    • Required Intermediate Microsoft Access
    • Required Advanced Microsoft Visio

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      Last Updated On: 12/9/2015