Specialist, Provider Contracting Operations at Prospect Medical Holdings, Inc. in Orange, California
Posted in General Business 20 days ago.
Type: Full-Time
Job Description:
The Senior Business Analyst is responsible for the successful gathering and documentation of detailed project requirements as assigned by the VP of Program Management Office. Projects may be moderately to highly complex and could involve a diverse set of components with cross functional departments for the key strategic or operational initiatives of the company. Projects cover a variety of operational initiatives including new market, contract launches, risk conversions, new service line implementations, MSO Client/Health Plan on boarding, M&A, Government & Regulatory compliances, Technology implementation, Clinical integration, Practice acquisitions, etc. This is a key position who will serve as the liaison between the customer/user community and the implementation teams to gather, analyze, interpret, clarify, and develop high level and detailed business requirements on the assigned projects and validate and ensure that the project is meeting the requirements during each phase. The Business Analyst will work as the voice of the customer (internal or external) and will be responsible for eliciting the actual needs of stakeholders into business requirements definition. Responsibilities will also include managing small scale projects independently and mid to large-scale projects in collaboration with Project Managers. Sharp analytical skills to conduct and manage outcomes of various studies which include reviewing, forecasting, trending, and presenting information for operational and business planning. The Sr. BA will also be responsible for enhancing and managing PPM tool, PMO Tools and templates, and PMO reporting. Serve as the lead to gather, analyze, interpret, clarify, and develop business requirements on the assigned projects and validate and ensure that the project is meeting the requirements during each phase and at closure.
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Elicit, understand, and document business requirements, related business rules and business processes for business solution delivery. Perform business analysis and create detailed business and technical requirements, current and future process flows, gap analysis, mapping documents, etc. Document business requirements. Present business and technical requirements to development teams and ensure conditions of acceptance are understood. Be responsible for answering questions from the team members and removing requirement roadblocks to success.
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Develop and recommend alternative solutions by preparing and evaluating alternative workflows. Partner with business and IT to design and facilitate the deployment of integrated solutions (people, process, technology & organizational); ensure the end-to-end solution delivers the required business results.
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Develop use cases, test plans, test cases, define and document procedures and workflows, coordinate UAT and provide user documentation, user training, and post implementation support. Drive adoption of the designed processes and solution with stakeholders. Upon implementation, drive knowledge transfer to Operational units
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Job Profile:
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Deliver detailed requirements - 10%
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PPM Tool enhancement, Administration - 30%
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PMO Reporting /Tools and Templates - 30%
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PI activities/ Assess Future Improvement needs and Process Mapping - 10%
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This role is 100% remote.
\nWith approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.Required Education/Experience:
- Bachelor's degree required; advanced degree preferred
- Five or more years' experience as an analyst in healthcare project management with some technical background.
- Knowledge of HIPAA compliance issues are vital.
- Must have strong working knowledge of MS Word, MS Project, MS Excel, and Visio
- Knowledge of document generation, technical knowledge, report creation required
- Process improvement experience
- Strong analytical and critical thinking skills
- Problem solving skill; the ability to systematically analyze problems, draw relevant conclusions, recommend solutions and devise appropriate courses of action
- Strong reasoning, with a high level of attention to detail.
- Superior verbal/written communication, relationship-building and time management skills.
- Ability to develop creative solutions for complex organizational and business issues.
- Ability to manage competing and changing priorities
- Need flexibility to go with the business decisions
- Ability to take direction
- Knowledge of Health Plan, Hospital and Medical Group/IPA relationships
- Creative, self-confident, and flexible
- Work independently and in group settings with strict deadlines
- Self-starter and able to work with minimal supervision
- Ability to adapt to changing priorities and to manage various projects simultaneously.
- Work independently on assigned projects and mentor team members
- Good organizational skills and the ability to handle multiple activities with changing priorities simultaneously.
- Strong desire to learn.
- MS SharePoint, MS Form, Project Server experience (behind the scenes for project online), Power Automation Platform and Power BI
- Effective oral, written and communication skills.
Preferred Education/Experience:
- Certification in related fields
- Business Analyst Certification
- MS Power Platform Developer Certification
- MS Power BI Data Analyst Certification
Knowledge/Skills/Abilities:
- Strong analytical and critical thinking skills
- Problem solving skill; the ability to systematically analyze problems, draw relevant conclusions, recommend solutions and devise appropriate courses of action
- Strong reasoning, with a high level of attention to detail.
- Superior verbal/written communication, relationship-building and time management skills.
- Ability to develop creative solutions for complex organizational and business issues.
- Ability to manage competing and changing priorities
- Need flexibility to go with the business decisions
- Ability to take direction
- Knowledge of Health Plan, Hospital and Medical Group/IPA relationships
- Creative, self-confident, and flexible
- Work independently and in group settings with strict deadlines
- Self-starter and able to work with minimal supervision
- Ability to adapt to changing priorities and to manage various projects simultaneously.
- Work independently on assigned projects and mentor team members
- Good organizational skills and the ability to handle multiple activities with changing priorities simultaneously.
- Strong desire to learn.
- MS SharePoint, MS Form, Project Server experience (behind the scenes for project online), Power Automation Platform and Power BI
- Effective oral, written and communication skills.
Knowledge/Skills/Abilities:
- Strong analytical and critical thinking skills
- Problem solving skill; the ability to systematically analyze problems, draw relevant conclusions, recommend solutions and devise appropriate courses of action
- Strong reasoning, with a high level of attention to detail.
- Superior verbal/written communication, relationship-building and time management skills.
- Ability to develop creative solutions for complex organizational and business issues.
- Ability to manage competing and changing priorities
- Need flexibility to go with the business decisions
- Ability to take direction
- Knowledge of Health Plan, Hospital and Medical Group/IPA relationships
- Creative, self-confident, and flexible
- Work independently and in group settings with strict deadlines
- Self-starter and able to work with minimal supervision
- Ability to adapt to changing priorities and to manage various projects simultaneously.
- Work independently on assigned projects and mentor team members
- Good organizational skills and the ability to handle multiple activities with changing priorities simultaneously.
- Strong desire to learn.
- MS SharePoint, MS Form, Project Server experience (behind the scenes for project online), Power Automation Platform and Power BI
- Effective oral, written and communication skills.
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