Business Analyst-Healthcare Claims

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Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

• Work-life balance - This is a remote role! Applicants must work from MD, VA, DC, PA, DE, or FL
• Medical, Dental, and Vision Insurance.
• 403B Savings Plan w/employer contribution.
• Paid Time off & Paid holidays.
• Employee and Dependent Tuition assistance benefits.
• Health and wellness programs and MORE!

Who you are:

As a Business Analyst in Health Services for Johns Hopkins Health Plans, you will perform data analysis, and review of processes and workflows within our clinical teams, in addition to implementing new processes and creating efficiencies within the end product delivery. You possess a strong analytical mindset and excellent problem-solving skills. You have a deep understanding of the healthcare industry, particularly in managed care and health insurance. You have a solid background in data analysis and proficient in using relevant tools and software. You possess strong communication skills to effectively collaborate with various stakeholders and present complex findings in a clear and concise manner. Additionally, you are detail-oriented and able to maintain focus while working with large datasets. You have the ability to resolve issues quickly, make decisions, and institute change when appropriate.

What you'll do:

• Work closely with external vendors to ensure accuracy and efficiency.
• Demonstrate a strong background in claims examination and benefit knowledge.
• Interpret and differentiate between configuration needs in the Claims Editing System versus the claims benefit configuration platform.

What you'll bring:

• 1+ years of OPTUM Claims Editing Software configuration experience, or other relevant configuration of claims editing software skills
• 2+ years of claims analysis and reporting experience
• Coding experience is preferred, but not required
• Vendor relationship skills
• General medical benefit knowledge required
• Basic SQL experience
• Platform knowledge of HealthSuite or Facets claims systems preferred

Bachelor's Degree in Business, HealthCare Management or related field preferred. Additional related work experience may substitute for some educational requirements.

Salary Range: Minimum 28.47/hour - Maximum 47.00/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.