Remote Jobs
Senior Analyst - Remote
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Job Description
- Req#: 2284147
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $140,600 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.
- Supportive and inclusive work culture focused on health equity
- Recognition and incentive programs to reward performance
What to Expect (Job Responsibilities):
- Apply process excellence principles to develop innovative solutions that enhance business operations within the PA experience
- Use insights from quality reporting, analysis, and audits to ensure adherence to regulatory requirements and organizational standards
- Mentor junior staff on audit, regulatory, and performance requirements
- Present complex plans and strategies to leaders and external partners to drive solutions and process improvements
- Analyze data across disparate sources to facilitate research in addressing regulatory and contractual adherence
What is Required (Qualifications):
- 2+ years of experience in pharmacy PA scope of services
- 2+ years of experience working within audit, regulatory, or performance processes
- 2+ years of experience working with standards across NCQA, URAC, CMS, ERISA, and state departments of insurance
- 1+ years of experience navigating Prior Authorization System (PAS)
- Proven excellent verbal and written communication skills
How to Stand Out (Preferred Qualifications):
- 1+ years of experience accessing articles in KnowledgeNow
- 1+ years of experience navigating data in RxClaim
- Experience creating and monitoring KPIs
- Experience working with PBM/plan contracts
- Experience with Power Automate, Power Apps, Power BI
#HealthcareServices #RemoteWork #CareerGrowth #CompetitiveBenefits #AuditCompliance
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