Position Summary:

The Long-Term Care Senior Business Analyst will be pivotal in analyzing and interpreting intricate healthcare data pertinent to Florida's Medicaid Long-Term Care Program. Collaborating closely with the Director of Long-Term Care, they will ensure that data insights drive informed decision-making and program enhancements. Working in tandem with internal teams, the Analyst will optimize caseload management and guarantee precise reporting. Extracting, transforming, and analyzing data from various sources, including claims data and electronic health records, the Analyst will collaborate with multidisciplinary teams

In the LTC department, the Senior Business Analyst will support non-technical LTC-specific processes, ensuring the accuracy of routine tasks and ad hoc projects by liaising with internal stakeholders and external business partners in care. Conducting comprehensive research and analyzing diverse data sources, they will translate complex business information into actionable insights. Expected to demonstrate innovation and proficiency, they will document specifications, generate reports, and conduct thorough data assessments independently and within a team.

This role involves addressing ongoing operational challenges and presenting findings effectively to various stakeholders, including peers, clients, and senior leadership, through written communication and verbal presentations. While not primarily technical, this position focuses on leveraging data to enhance healthcare outcomes for Medicaid Long-Term Care enrollees, predicting quality indicators and proposing solutions for utilization patterns.

Essential Duties and Responsibilities:

1. Analyzing data and conducting research to support billing processes.
2. Collaborating with internal teams to gather and document business requirements.
3. Ensuring the quality and accuracy of information products.
4. Independently designing and producing reports to meet business needs.
5. Investigating and resolving operational issues as they arise.
6. Presenting findings and recommendations to stakeholders at all levels.
7. AHCA Reports

• Enrollee Roster
• Caseload
• PDO
• DRTS
• Missed Services
• UTL

1. Provide weekly internal reports

• Next Face-to-Face Report
• Monthly Contact Report
• Internal Caseload Report
• Expense Report (Monthly)
• SDR Report

1. Caseloads

• New enrollee assignments
• Monthly reassignments – 1 CM to Facility reassignments
• Geo-Mapping
• Right sizing caseloads

1. Security Coordinator

• System Accesses

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Skills and Abilities:

• Demonstrated knowledge of the Florida Medicaid Long-Term Care program, including its policies, procedures, and regulations.
• Proficiency in statistical analysis and data manipulation techniques specific to Long-Term Care data sets.
• Demonstrated experience in analytical thinking, influencing, problem solving, verbal and written communications with meticulous attention to detail to ensure data accuracy and integrity in all reporting and analysis activities.
• Ability to identify anomalies or discrepancies in data sets and take appropriate corrective actions.
• Working knowledge of using data to deliver compelling storytelling to drive an impactful result.
• Using fact-finding and effective questioning techniques and diagnostic tools to identify and analyze problems.
• Effective collaborative mindset and proven process improvement skills.
• Flexibility to adapt to evolving program requirements, regulatory changes, and organizational priorities.
• Willingness to learn and acquire new skills as needed to support the evolving needs of the Long-Term Care program.
• Strong oral and written communication skills; ability to interact within all levels of the organization.
• Demonstrated ability to successfully plan, organize and manage projects, critical thinking, problem-solving, and the analysis, interpretation, and evaluation of complex information.
• Ability to conceptualize, create partnerships and facilitate change.
• Ability to tackle complex analytical challenges and develop innovative solutions to improve Long-Term Care outcomes.

Work Schedule:

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule. Staff are able to work from home 3 days a week and will report to the office 2 days a week.

*****The company reserves the right to change the work schedules based on the company needs.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 15 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

Qualifications

• Strong analytical skills with experience in data manipulation and synthesis.
• Ability to work both independently and collaboratively in a team environment.
• Excellent communication skills for effectively conveying complex ideas.
• Proficiency in technical tools and platforms relevant to business analytics.