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Responsible for performing high-level reporting, engaging in predictive trend analysis and making subsequent business process improvement recommendations for customer service and provider operations.
Research, understand, problem solve and report root cause of metric variances and propose possible business solutions.
Serve as subject matter expert regarding all process flows including understanding systems used and functions performed within each work type, dependencies/interactions and identification of potential impact resulting from changes
Assist in maintaining all project-related matters (e.g. action plans, tracking tools) and reporting to senior leadership as appropriate.
Responsible for leading cross-functional departmental planning sessions, and ensuring appropriate action planning results are executed.
Represent department in various task forces/committees, and presenting to executive and other senior leadership.
Coordinate project activity and facilitate project meetings with staff and inter-departmental partners.
Develop and maintain interdepartmental relationships to ensure proper involvement, cooperation and communication of changes are executed appropriately.
Builds and maintains positive business relationships with business partners at all levels of the organization, including executives.
Ability to support concurrent projects in an organized manner and meet agreed upon SLAs.
Participates in the formulation of project time estimates, and leverages cross-functional relationships.
Ensures adherence to quality processes and procedures.
Assist in the development and maintenance of various policies and procedures affecting the operations of the department.
Develops ad-hoc reports to conduct data analysis and validation.
Perform on-demand, rapid data analytics and reporting of multiple inputs/sources.
Develop and maintain comprehensive reports providing management with visibility to processor/team productivity and other departmental metrics.
Develop, document and implement process improvement opportunities.
Analyze trends, identity opportunities and recommend process and/or operational improvements.
Researches methodologies and conducts advanced metric reporting.
Provide ongoing operational analysis of process components, while identifying and implementing changes as necessary to improve the level of quality and efficiency as measured by key performance indicators.
Responsible for capturing and documenting metrics in support of the user acceptance testing and recommends improvements.
Assist in system requirements gathering and testing to ensure accuracy across systems.
May also assist in preparing various management related reports.
Perform all other related duties as assigned.
Required A High School or GED
Preferred A Bachelor's Degree in a related field
Required 3 years of experience in reporting, metrics analysis, quality and/or related function
Required 2 years of experience in working on interdepartmental projects
Preferred Other Health care analytics
Preferred Other Wellcare system knowledge
Intermediate Demonstrated analytical skills Ability to perform detailed review, research, and analysis to ensure accuracy of enrollment process in to Peradigm system
Intermediate Ability to analyze information and covert related activities into a comprehensive work plan
Intermediate Other Demonstrated technical expertise in performing quality reviews with analysis of results
Licenses and Certifications: A license in one of the following is required:
Required Advanced Other MS Office, including Excel, Powerpoint and Word