Business Analyst (Healthcare)

TL;DR

Business Analyst (Healthcare): Leading the development and implementation of programs and strategies to enhance business decision-making with an accent on Medicare Advantage enrollment and CMS guidelines. Focus on optimizing workflows, improving processes for membership reconciliation, and ensuring compliance with CMS thresholds.

Location: Hybrid; Must be based in Detroit, MI (2 days per week onsite Mon/Tues)

Company

hirify.global (S3) is a professional staffing firm providing specialized talent for diverse business needs.

What you will do

• Lead the development and implementation of business programs and strategies to enhance decision-making.
• Analyze data to identify insights that optimize organizational products and services.
• Develop and modify workflows to implement process improvements.
• Manage Medicare Advantage enrollment and disenrollment processes.
• Provide high-level support to internal and external customers.

Requirements

• 4+ years of experience in the Medicare Advantage field.
• Strong knowledge of CMS Guidelines (specifically Chapter 2) and compliance timeliness for discrepancy resolution.
• Hands-on experience with MARx and TRR.
• Knowledge of employer group Medicare Advantage Membership Reconciliation processes.
• High School Diploma required; Bachelor’s degree preferred.

Nice to have

• Experience with process improvement methodologies (e.g., Six Sigma).