Operations Reports Analyst

Why Choose Jefferson Health Plans?

We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members.

We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.

While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.

Perks of JHP and why you will love it here :

• Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
• Flextime and Work-at-Home Options
• Benefits & Wellness Program including generous Time Off
• Impact on the communities we service

We are seeking a talented and enthusiastic Operations Reports Analyst to join our team!

Analyze various operational statistics to produce reports, file comparisons and detailed payment / denial analyses for a variety of internal and external sources.

Develop and produce reports to meet regulatory requirements. Work with a variety of data sources and programs to perform comparative analyses.

Produce executive level summaries of complex data situations. Develop and generate standard weekly, monthly, quarterly and ad hoc executive summary dashboard reports that meet management and State requirements, including coordination of any needed programming for these reports.

As the Operations Reports Analyst, your daily duties may include :

Create standard weekly, monthly, and quarterly report metrics for Operations Divisions utilizing various tools , applications and I.

S. resources when necessary.

• Analyze all HP data for anomalies in processing functions and data integrity .
• Develop dash boards and executive summary reports utilizing statistical analysis.
• Analyze technical and financial issues to make recommendations that coincide with Operations Department initiatives.
• Analyze operational data, identify trends root cause analysis and resolution. Partner with quality review to establish audit methodology where applicable or make recommendations to improve business processes.
• Identify fluctuations in business processes document and escalate findings back with facts to appropriate business unit management staff timely.
• Prepare, analyze and communicate appropriate reporting measure to internal and external entities as required.
• Document and implement setup of specified reporting requirements for operations divisions during system upgrades and project implementations.
• Perform other related duties as assigned.

Qualifications

• Associates’ degree in related field preferred.
• 3 - 5 years experience, preferably in managed care reporting and data analysis.

Skills, We Value :

• Excellent oral and written communication skills.
• Ability to explain complex issues in a detailed and comprehensible manner.
• Ability to understand statistical variances and communicate explanations for those variances.
• Ability to interact successfully with staff at all levels of the organization.
• Personal computer skills including proficiency in Excel, Word and Access. Some data warehouse experience preferred as well as experience using statistical analysis software .
• Prior claim / managed care experience is helpful.
• Ability to work independently and comply with stringent project completion timeframes
30+ days ago