Business Management Analyst

JOB SUMMARY:

The Encounter Management Analyst analyzes encounter data for assigned markets to determine root causes and resolve moderate to complex errors resulting from internal processing and encounter file submissions. This position will partner with IT and other AMERIGROUP business units to develop and implement solutions to encounter errors.

PRIMARY RESPONSIBILITIES:

1.Monitor and coordinate state encounter file reporting (file acknowledgement, error reporting) for assigned markets
2.Design, develop, and utilize tools to identify and track internal errors and state rejections
3.Research and resolve encounter discrepancies identified through monthly quality reports
4.Develop and perform complex queries of encounter data to identify root causes of encounter errors
5.Partner with the appropriate AMERIGROUP departments and state agencies to develop solutions to root causes and create implementation plans
6.Assist with the implementation of solutions as directed by management
7.Write, execute and verify test cases for all encounter related testing
8.Establish and enhance repeatable processes to monitor, track, and resolve encounter errors
9.Identify reports needed to adequately monitor encounter management performance and work with business partners to implement and manage reporting for AMERIGROUP
10.Respond, within agreed upon performance assurances, to encounter verification requests
11.Interface with appropriate Health Plan, State and AMERIGROUP representatives, as needed
12.Assist in managing customer expectations
13.Assist other Encounter Management Analysts and Sr. Encounter Market Analysts as assigned
14.Perform other duties as assigned or requested
REQUIREMENTS
Education and Experience:
•Bachelor’s Degree in Information Systems, Health Care Management, and/or Business.
•Minimum of 2 years experience, consisting of a combination of business or systems analysis, healthcare industry, and/or claims processing.
•Comprehensive claims processing knowledge, preferred.
•Experience in a team oriented and/or productivity oriented environment, helpful.

Certification and Licensure:
•None required.

Knowledge and Skills:
•Understand data modeling concepts (e.g. the entity-relation model) and their application
•Strong knowledge of the inter-relationship among various managed care operational areas
•Strong technical and data analysis skills
•Advanced knowledge and experience using Microsoft Access and other database query tools required
•Strong knowledge of Microsoft Excel and Word
•Strong customer service orientation
•Detail oriented with excellent analytical skills, ability to identify problems and develop solutions.
•Basic project management skills
•Strong communication, presentation and team work skills. Good written communication skills
•Ability to set priorities, meet deadlines, and coordinate several projects at once in a demanding work environment
•Ability to function under pressure
•Appreciation of cultural diversity and sensitivity towards target population

Physical Requirements:
•Must be able to conduct and facilitate meetings.
•Must be able to operate a computer.
•Must be able to operate a telephone.
•Travel upon request

Please apply online at: www.amerigroupcorp.com