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 BA III position is a senior Business Analyst role within the Business Intelligence and Analytics department. This position serves as a lead developer and analyst, responsible for independently working on significant projects. The BA III will be involved in developing queries, documentation, output/results, and analysis. Additionally, this role requires effective communication with internal and external groups/organizations, gathering requirements, translating them, and executing upon them while coordinating with BAI's and BA II's.

JOB SPECIFICATIONS AND CORE COMPETENCIES

Core Business Reporting, Star Plus Regulatory Reporting, and Data Analysis:
Create, review, document, and deliver all Core Business and Star Plus Regulatory Reporting. Collaborate with Subject Matter Experts (SMEs) to develop reports and ensure accuracy. Conduct complex analysis and reporting on data. Conduct ad hoc reporting based on business requests for Star Plus and Core Business as needed.

Business and Communication Requirements:
Gather, translate, document, and execute on business requirements using SQL, SSRS, Microsoft Suite, Quest Analytics, and other analytic tools to fulfill complex business requirements. Communicate with internal and external business teams and present work.

HEDIS Submissions:
Create, review, and deliver HEDIS files to Vendor. Review for accuracy.

Risk Adjustment:
Create, review, and deliver Risk Adjustment files to Vendor. Review for accuracy.

Leadership:
Lead, educate, and organize other analysts in the completion of projects.

Other Duties as Assigned


QUALIFICATIONS:
Education/Specialized Training/Licensure:

  • Bachelor's Degree required.
  • Specialization in Business Analytics preferred.


Work Experience (Years and Area):

  • 5 years of relevant experience.
  • 1 year in Star Plus preferred 


Management Experience (Years and Area): N/A

Software Proficiencies: Software Proficiencies:

  • Strong proficiency in SQL, Microsoft Suite, SSRS, and Power BI.
  • SSRS


Other:

  • Excellent problem-solving skills, attention to detail, and ability to work independently.
  • Strong communication and leadership skills

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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