Prominence Health · 3 hours ago
Operations Analyst
Reno, NV
Full-time
Onsite
Mid, Senior Level
5+ years expProminence Health is a value-based care organization focused on bridging the gap between health systems and independent providers. The Operations Analyst position is responsible for supporting business objectives through the design and implementation of reports, conducting compliance reviews, and serving as a liaison for claims issues.
Health CareHospitalMedical
Responsibilities
Provides support regarding standard procedures and best practices to meet business objectives
Responsible for the design, development, implementation and support of reports and/or extracts
Working with Business Leaders, subject matter experts and vendors to gather and document reporting requirements to meet business needs
Plans and executes independent, objective internal audits designed to test and confirm compliance with applicable State and Federal laws
Analyzes and understands regulatory requirements and applies identified requirements to business operations when developing and conducting compliance reviews
Monitors the progress, up to the remediation, of all deficiencies once identified
This position requires in-depth knowledge and understanding of claims processing functions
Ability to analyze and interpret fee schedules, contracts and network data entry for opportunities for data clean-up projects
This position works with multiple payers/clients as the liaison for claims issues and all other communication
Create and analyze system QA reports to ensure the integrity of the data entered into multiple systems
Supports the fulfillment of internal/external audits as required
Performs other job-related duties and projects as assigned
Qualification
Required
High school or equivalent. Associate degree preferred
5 years health plan operations experience or health services experience preferred
Good organization skills with ability to prioritize multiple activities in a rapidly changing environment
Excellent interpersonal, communication and organizational skills with the ability to interact with all levels of personnel within the organization
Ability to understand from a systems level perspective the interdependence of one unit or system upon another, and how changes in any one part affect all others
Demonstrated ability and professional concern for bringing together knowledge of operations and information needs of users
In-depth knowledge and understanding on claims processing functions
Ability to analyze, interpret and configure annual, quarterly and monthly fee schedules, contracts and ongoing maintenance
Ability to effectively communicate in English, both verbally and in writing
Excellent computer skills
Self-starter, Resourceful and able to execute projects in a fluid and fast paced environment
Good organization, management, and reporting skills
Attention to detail
Strong knowledge and experience with MS Office, MS Project, MS Visio with the ability to use these and other tools to provide meaningful analytics
Ability to effectively contribute as a team member or on individual assignments
Must be able to work independently, providing management with status updates
Excellent analytical and problem-solving skills
Strong customer service focus
Knowledge of operational processes within the Health Plan
Strong negotiation and persuasion skills
Excellent written and verbal communication skills
Ability to interact with all levels of personnel
Benefits
Loan Forgiveness Program
Challenging and rewarding work environment
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
401(K) with company match and discounted stock plan
SoFi Student Loan Refinancing Program
Career development opportunities within UHS and its 300+ Subsidiaries!
Company
Prominence Health
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
David Hsieh
CFO
Patrick Koltz
Chief Operating Officer
Company data provided by crunchbase