128 Business Analyst Jobs in Los Angeles, CA
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gtt is Hiring a Business Analyst Near Los Angeles, CA
- Pay range $42.71 - $55.53/hr
- The Enterprise and Network Oversight Business Analyst III (BA III) is an integral part of supporting the department in maintaining a centralized, integrated, proactive Enterprise Performance Optimization Program (Enterprise POP) and a Network Performance Optimization Program (Network POP) to ensure Plan and Network performance excellence.
- The Business Analyst individually and collaboratively researches federal, state, contractual, accreditation, and Plan-imposed requirements applicable to the Enterprise and client's Plan Partners and Provider Network for all lines of business (Medi-Cal, Personal Assistance Services Council (PASC-SEIU), client-covered (LACC) and LACC Direct (LACC/D), and the Cal MediConnect Program (CMC) and Dual-Eligible Special Needs Plan (D-SNP)).
- The Business Analyst is responsible for maintaining subject matter expertise of all performance standards corresponding to an assigned scope of responsibility. For any given project or issue, the Business Analyst identifies and actively engages a complete group of stakeholders to assure that related fiscal and operational impacts, and risk and liability-producing factors attendant to the implementation of requirements or policy are properly considered and adjudicated by the right parties.
- In collaboration with key stakeholders, the BAIII performs proactive gap and risk analyses; tracks, trends, analyzes, and reports results to enable leadership to make evidence-based decisions to remediate extant deficiencies and engage in process improvement to achieve optimal internal and external performance. Acts as a Subject Matter Expert, and serves as a resource and mentor for other staff.
- Elicits, documents, analyses, communicates, tests, verifies, and systematically tracks federal, state, contractual, accreditation, and Plan-imposed requirements for the Enterprise, the Provider Network, and the client's Plan Partners.
- Performs criteria-based internal and external monitoring, proactive gap analyses and risk assessments; reports results and collaborates to take corrective action and perform ongoing performance improvement planning.
- Ensures that the client, its Plan Partners, Network, and vendors demonstrate adherence to applicable requirements in timely updated policies and procedures, workflow(s), and other artifacts.
- Oversees all phases of Enterprise, Network, and Plan Partner performance related to an assigned scope, including: helping to research and distill requirements into actionable form and set performance standards, developing and monitoring metrics to track ongoing fidelity to these requirements, and taking corrective action to remediate issues of non-compliance. This includes establishing Key Performance Indicators (KPIs or Metrics) to systematically assess, track, and trend internal client performance and external Network and Plan Partner performance.
- Partners with the functional business leaders, Compliance, Legal, and Quality Improvement to coordinate responses to regulatory inquiries and actions, and to the NCQA, and assists in preparing for and responding to internal and government audits; examines audit findings and collaborates to respond to cited deficiencies; and monitors implementation of corrective action plans.
- Proactively inform the organization, senior Leadership, and relevant committees, including the Internal Compliance Committee (ICC) of possible risks and issues with sub-optimal internal and external criteria-based performance, and develop remediation and corrective action plans, as appropriate.
- As a Subject Matter Expert, develop and conduct training on unit processes, for lower-tiered positions.
- Performs other duties as assigned.
- Bachelor's Degree
- In lieu of a degree, equivalent education and/or experience may be considered.
- Master's Degree
- Juris Doctor Degree or Doctor of Law Degree (J.D.)
Required:
- At least 5 years of experience in contract and/or regulatory and/or accreditation requirements analysis in managed care or other related industries; or, experience in Healthcare Compliance, or other Compliance-related fields.
Required:
- Regulatory research, business writing, Excel, PowerPoint, Word, Outlook.
- Demonstration of both qualitative and quantitative analytical skills.
- Proven ability to work with a diverse group of people, including external entities, physicians, support staff, coworkers and management.
- Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.
- Demonstrated critical thinking and problem-solving skills.
- Strong organizational and communication skills to build and foster effective relationships.
- Strong written and verbal communication skills with the ability to quickly gather, summarize, and meaningfully communicate dense, complex content clearly to all levels of the client organization, including Executive Leadership, stakeholders, facilitators, partners, and external regulating bodies.
- Strong elicitation and process documentation skills.
- Ability to respond resourcefully to change and ambiguity, generate and champion ideas and initiatives, and thoughtfully identify the connections within the organization to effectively integrate efforts across units and functions.
- Strong knowledge of Governance, Risk, and Compliance (GRC) Systems, Tableau, Visio
- Licenses/Certifications Required
- Certified HealthCare Compliance (CHC)
- Certified in Healthcare Compliance Fellow (CHC-F)
- Certified Compliance & Ethics Professional (CCEP)
- Mainly remote candidate- But ideal if local as may be an occasional on-site.
- Medical, Vision, and Dental Insurance Plans
- 401k Retirement Fund
- Our client is on a mission that makes coming to work more than just a job. They make a direct and positive impact on the vulnerable and underserved communities of Los Angeles by providing access to quality healthcare. As an organization undergoing transformational change, they welcome an entrepreneurial make-a-difference spirit with new innovative ideas for streamlining processes for the benefit of their members.
- This organization needs more than just nurses. Are you a dynamic professional with a passion for serving communities in need through the implementation of new business processes? Does the detail-oriented part of you take pride in creating business flows that are effective and accurate? If so, our client is looking for you.
#LI-GTT
24-07363
Job Summary
Full Time
$106k-129k (estimate)
06/15/2024
06/18/2024
gtt.co.gy
Georgetown
<25
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