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Job Summary:
The Operations Business Analyst IV oversees the business analysis initiatives to drive operational excellence and efficiency of existing processes and systems, leads cross functional process improvements, and aligns solutions with organizational strategy.
Assist in defining and implementing best practices for business analysis, ensuring alignment with enterprise architecture and long-term organizational goals
Lead end-to-end process redesign initiatives, including feasibility studies, cost-benefit analyses, and ROI assessments to prioritize high-value projects
Participate in the development of operational readiness frameworks for seamless implementation of new systems/processes, including policy documentation and post-launch performance tracking
Act as the primary liaison between stakeholders, technical teams, and executive leadership to deliver high-impact outcomes
Responsible for managing and maintaining policy and performance of claim lifecycle and implementation activities to ensure performance objectives are met including issue tracking and resolution
Advise executive leadership on change management strategies, ensuring initiatives align with business objectives and regulatory requirements
Perform cost-benefit and return on investment analyses for proposed initiatives to aid decision-making process as well as collect and analyze data in support of business case creation and realization
Ensures operational effectiveness by assisting in strategic and business planning, including business, financial, and operational goals and objectives definition as well as feasibility studies
Recognizes and proactively manages scope and expected benefits across the organization’s strategic initiatives and process improvements Perform operational readiness processes and associated documentation which may include creating, reviewing, revising and enforcing company and department policies and procedures.
Take a leading role in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information.
Develop, document and perform testing and validation as needed
Mentor Business Operations Analyst/Associates to achieve cross-functional capability with project execution and subject matter expertise
Perform any other job duties as requested
Education and Experience:
Bachelor’s degree in business administration, healthcare management, a related field or equivalent years of relevant work experience is required
Seven (7) years of health care operations experience in insurance, managed care, or related industry is required
Competencies, Knowledge and Skills:
In-depth knowledge of regulatory reporting and compliance requirements
Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
Demonstrates excellent analysis and collaboration skills
Ability to multi-task and juggle competing priorities
Exceptional communication (verbal and written), facilitation and presentation skills
Strong interpersonal, leadership and relationship building skills
Critical listening and thinking skills
Customer service oriented
Effective time management and prioritization skills
Decision making and problem solving skills
Licensure and Certification:
Six Sigma or other performance improvement experience is preferred
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$94,100.00 - $164,800.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary Organization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.