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Senior Business Analyst Consultant - Remote

Work from home Full-time role Hiring

Employer Industry: Healthcare Services Why consider this job opportunity... - Salary up to $190,400 annually - Comprehensive benefits package including equity stock purchase and 401k contribution - Opportunity for career advancement and growth within the organization - Work remotely from anywhere within the U.S. - Incentive and recognition programs available - Supportive and inclusive company culture focused on health equity What to Expect (Job Responsibilities): - Coordinate with Market, Finance, Product, Medical Directors, and Healthcare Economics to identify and implement payment integrity opportunities - Develop and implement payment integrity solutions through research and analysis of data and local business processes - Lead program management for all California payment integrity services - Create business cases to influence market partners and stakeholders for prioritizing new initiatives - Ensure adherence to state and federal compliance policies and operational metrics What is Required (Qualifications): - 5+ years of experience in the healthcare industry - 5+ years of experience working within MA, Medicaid and/or commercial lines of business - Experience with product/vendor implementations and end-to-end process ownership for payment integrity programs - Proficiency in Microsoft Office: Word, Excel, PowerPoint, and Visio - Proven ability to manage competing priorities and engage with clients effectively How to Stand Out (Preferred Qualifications): - 1 or more of the following certifications: CPC, CPCO, AHFI, HCAFA, CFE - Experience interpreting provider contractual agreements - Experience managing a comprehensive portfolio of programs - Proficiency in performing financial analysis/audit - Comfortable with PMPM calculations and financial goal accountability #HealthcareServices #RemoteWork #CareerGrowth #CompetitiveSalary #DiversityAndInclusion At Talentify, we prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. Talentify is not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer Apply Job!

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