Medicare & ACA Sales Operations Analyst

Your career starts now. We''re looking for the next generation of health care leaders.At AmeriHealth Caritas, we''re passionate about helping people get care, stay well and build healthy communities. As one of the nation''s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we''d like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at This role is eligible for a $5,000 sign-on bonusResponsibilities:Support Medicare & ACA front office operations by managing various workflows essential to effective execution of corporate strategy. Ideal candidate will be able to work independently with various areas throughout department and larger org to understand, address, and complete complex projects related to operational goals. Independently lead efforts to gather & validate business requirements to support software and system upgrades. Perform user acceptance & regression testing to ensure continuity of data.Develop and interpret reporting to support various operational areas, provide forecasting and metrics, and respond to audits. Ability to analyze and visually interpret large data sets is critical.Works with stakeholders and senior leadership to document processes, create and update policies, and develop systems and methods for monitoring & improving ongoing operations. Process Improvement experience (LEAN/6σ) is a plus.Responsible for Analysis, Maintenance, and Deduplication of data within ACFC Software and systems. Ideal candidate will be able to independently gather, identify, analyze and correct data discrepancies from a variety of sources.Monitor and troubleshoot ongoing processes to ensure continuity of critical business functions. This includes generating and distributing daily/weekly/monthly reporting to stakeholders, and monitoring file loads and data transfers for fallout and missing information.Manage small-to-medium scale projects including CAP responses, audit responses, software upgrades, and process enhancements. Act as SME to provide status and feedback on larger departmental and corporate projects.Education/ Experience: Bachelor''s Degree preferred (or equivalent experience).Microsoft Office - Excel, Access, Word, Outlook, Project, Visio. SharePoint & One Note.Process improvement methodologies (LEAN/6σ).CMS Medicare & ACA and/or Medicaid technical experience and understanding of regulatory requirements.3 to 5 years experience.Other Skills:Proficiency in Microsoft Office Suite.Excellent Verbal and Written communication.Excellent Analytical and Research skills.Familiarity with Medicare & ACA, Medicaid, and/or Insurance industry preferred.Familiarity with CRM, Enrollment, Care Management, Call Center systems and software is a plus.Familiarity with Structured Query Language (SQL) and BI tools (Tableau). BackShareApply Now

Created: 2021-11-29