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Business Analyst

HCL America Inc.

This is a Contract position in Glen Allen, VA posted October 11, 2020.

7+ years of experience working in an operations role at a health plan 4+ years of Healthcare experience in any of the following Government Programs, PBM, Clinical Health Management, Core Administer Delivery, Program Management, Product Management, or Network Management 2+ years of experience in one or more of the following Operational business process improvement, business process analysis, benchmark analysis or workflow analysis Ability to work on claims with different LOBs such as Commercial, Medicare, Medicaid etc. Knowledge and experience of Medicare Medicaid state level reporting levels Strong KnowledgeExperience with Dimensional Modeling Strong understanding of healthcare data formats, standards, and can map them to CMS and state level reporting needs Good understanding on the lifecycle of claims adjudication Possess good exposure on the various claim functionalities such as Edits, COBs, claims adjustments, Episodes etc.