Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY
The Business Analyst acts as a vital bridge between the Medical Affairs department and the broader organization, focusing on data analysis, project management, and reporting for the STAR+PLUS program. The role entails providing analytical support, fostering operational improvements, and ensuring the successful execution of project implementations.

The Business Analyst must be comfortable navigating both clinical and non-clinical operations, analyzing extensive datasets to optimize business processes and develop detailed reports. Additionally, the role includes daily data tracking, transparency monitoring, and variance reporting to senior management.

The Business Analyst should exhibit independent problem-solving skills, strategic and tactical thinking, and effective decision-making. Exceptional analytical, communication, and facilitation skills are required when interacting with department leaders and external partners.


JOB SPECIFICATIONS AND CORE COMPETENCIES

Data Analysis:

  • Develops business performance reports and dashboards, analyzing data to identify performance deviations and anomalies.

Collaboration with IT:

  • Partners with IT to monitor all inbound and outbound transfer packets, ensuring that Service Coordinators are notified of MCO status.

Operational Amplification:

  • Aids in the development and implementation of operational improvements to satisfy regulatory requirements.

Performance Adherence:

  • Works with the Performance Adherence team to create robust audit tools.

Business Strategy:

  • Collaborates with business line leaders to develop decision support tools
  • Coordinates planning processes and prepares content for quarterly medical affairs Townhalls and monthly QIC meetings.
  • Undertakes system testing, documenting test results thoroughly.
  • Facilitates meetings with internal and external stakeholders.
  • Other duties as assigned.


QUALIFICATIONS:

  • Education/Specialized Training/Licensure: Bachelor's Degree required

 

  • Work Experience (Years and Area): 2 years

 

  • Software Proficiencies: MS Office, Visio, Tableau, Power BI


Job Family/Job Title Competencies:

  • Analytical Thinking
  • Problem Analysis
  • Attention to Detail
  • Planning and Organizing

Additional competencies:

  • Proficient in using data analytical tools such as SQL, Excel visualization tools, Tableau, Power BI
  • Familiar with BI tools to create reports, dashboards, and interactive visualizations.
  • Above Average communication skills
  • Above average in Writing /Composing and creating ppt presentations
  • Proficient in using process analysis tools (Visio)


INTERPERSONAL SKILLS:

  • Cross-functional effective collaboration across business lines and Executive Leaders
  • Active listening skills
  • Good time management skills

Application Instructions

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