Business Analyst, Quality & Business Performance

About the Business Analyst, Quality & Business Performance:

The Business Analyst will be responsible for analyzing, documenting, and optimizing business processes within the operational performance teams. This role requires a strong understanding of healthcare operations, data analysis, and project management. The ideal candidate will work closely with stakeholders to identify opportunities for improvement and implement effective solutions based on data-driven trends and analyses.

This position is eligible for remote work, but quarterly travel will be required to the corporate office located in Tampa, Florida.

Business Analyst, Quality & Business Performance Essential Functions and Responsibilities:

• Design, build, and conduct data analysis across multiple datasets to identify trends, patterns, and opportunities for improvement in healthcare processes.

• Assist in the design and implementation of healthcare IT systems and solutions, ensuring they meet business needs and regulatory requirements.

• Create and deliver presentations and reports to communicate findings, recommendations, and project updates to stakeholders.

• Facilitate workshops and meetings with stakeholders to identify and prioritize business needs and solutions.

• Monitor and evaluate the effectiveness of implemented solutions and make adjustments as necessary.

• Develop and maintain detailed business process documentation, including workflows, data models, and use cases for all analytics performed.

• Stay up-to-date with industry trends, regulations, and best practices in healthcare business analysis.

Business Analyst, Quality & Business Performance Minimum Qualifications:

• 3+ years of experience in healthcare operations, authorization or claims, with a focus on quality and business performance processes.

• Bachelors degree in Business Administration, Healthcare Management, Information Systems, Health Informatics, or a related field, or 7+ years direct, applicable experience in lieu of a degree.

• Strong analytical and problem-solving skills with the ability to interpret complex data and provide actionable insights.

• Proficiency in data analysis tools and software, such as Excel, Tableau, Power BI, SQL, and data visualization tools.

• Knowledge of healthcare regulations, standards, and best practices, including authorization and claims editing systems.

• The ideal candidate is analytical, detail-oriented, and exhibits systems thinking to troubleshoot and improve validation workflows. Experience with healthcare analytics platforms and tools.

Business Analyst, Quality & Business Performance Preferred Qualifications:

• Masters degree in Health Informatics, Information Systems, Healthcare Administration, or a related field.

• Demonstrated expertise in clinical claims editing systems.

• Strong knowledge of regulatory requirements and compliance standards in healthcare, including HIPAA, CMS guidelines, and payer-specific rules.

• Proven track record of process improvement, automation in quality or business performance.