Operations Manager Healthcare Analyst

If you are looking for a role with a health system to provide data analysis, guide statistics for strategy while also managing our guest relations team (switchboard and front desks), this is the role for you.  This position works on-site directly with the VP and AVP of Operations.  Hospital teams rely on this role's ability to provide data review for improving outcomes.  From conducting surveys to analyzing productivity, a keen eye for performance is required.   

We are seeking a Business Analyst with expertise in healthcare claims processing, data mining, referral source analysis, and physician referral patterns to support our operations. The ideal candidate will have a strong working knowledge of hospital claims, payers, diagnosis codes, ICD-10 coding, and reimbursement models, along with experience analyzing physician referral patterns and leakage trends. This role will be critical in identifying opportunities to optimize financial performance and enhance patient retention strategies.

Key Responsibilities:

·       Conduct data mining analysis on hospital claims, payers, diagnosis codes, ICD-10 coding, and reimbursement models.

·       Analyze referral sources to track trends, assess provider relationships, and improve patient retention.

·       Evaluate physician referral data to identify gaps in utilization and develop strategies to reduce out-of-network referrals.

·       Develop dashboards and reports for insights in claims processing, payer performance, referral patterns and leakage.

·       Work closely with stakeholders to optimize patient flow, reimbursement efficiency, and provider network alignment.

·       Ensure compliance with healthcare regulations, insurance policies, and reimbursement standards.

·       Collaborate with IT teams to enhance data systems and improve analytics capabilities.

·       Support financial and operational decision-making by providing data-driven recommendations.

Responsibilities  

• Partner with stakeholders across hospital system departments.
• Use data analytics tools to create ad-hoc or automated reports to support hospital operations.
• Propose actionable insights derived from created reports to optimize efficiency or meet project needs.
• Manage or assist with management of special projects and initiatives.
• Support hospital operations department and administration with ad-hoc tasks as requested.
• Management of multiple different projects and initiatives with varying deadlines.
• Use of specific tech stack including, but not limited to, Paylocity, Microsoft Office Suite (Excel, PowerBI, PowerPoint, Teams, etc.), PandaDoc, Optum Market Advantage, Premier Operations Advisor, and the NCHA HIDI database. 

Required skills and qualifications

• Bachelor’s degree in business analytics, business administration, information technology, computer science, or related field(s).
• Clinical knowledge required.
• Proficiency in Excel, PowerBI, Microsoft Suite products.
• Proven analytical abilities.
• Familiarity with project management methodologies.
• Excellent communication skills, with an ability to translate data into actionable insights.  

Preferred skills and qualifications

• Master’s degree in business analytics, business administration, information technology, computer science, or related field(s).
• Strong working knowledge of relevant Microsoft applications, particularly Microsoft Excel and PowerBI.
• Proven ability to organize and manage multiple different projects and meet varying deadlines.
• Proficiency with data visualization, report creation, and report automation.
• Proficiency with SQL and database management
• One or more years in business analytics, clinical analytics, financial analytics and/or project management.

Essential Physical Requirements

• Must possess full range of body motion to pass basic FIT test for position to include walking, kneeling, standing, pushing, pulling, bending, stooping, reaching and sitting for extended periods of time. Must be able to lift and carry up to 30 pounds