Healthcare Business Analyst IV (MCO, Claims , SQL)

posted on June 16, 2020

Job Description

Location: Tempe, AZ

Duration: Permanent


Position Purpose: Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements.

  • Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
  • Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes
  • Resolve issues and identify opportunities for process redesign and improvement
  • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements
  • Evaluate risks and concerns and communicate to management
  • Coordinate with various business units and departments in the development and delivery of training programs
  • Develop, share, and incorporate organizational best practices into business applications
  • Oversee all changes to departmental policies and procedures, including communicating and implementing the changes
  • Serve as the subject matter expert on the assigned function product to ensure operational performance

 What are the 3-4 non-negotiable requirements on this position?

  • Must Have great rounded knowledge Managed Care org and Clinical knowledge
  • Medical management, UM, Authorization, Hospital experience
  • G&A, Hedis & SQL experience is a must but 2nd to Clinical and Managed care experience
  • This is not an IT or Data heavy role. Need someone with expert clinical knowledge.


  • Bachelor’s degree in related field or equivalent experience
  • 6+ years of business process or data analysis preferably in healthcare or 5+ years of HEDIS analysis
  • Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Project management experience preferred.



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