This position is with the Division of Integrated Healthcare in the Office of Managed Healthcare. The Senior Business Analyst (SBA) oversees the exchange of Medicaid and CHIP eligibility, enrollment and/or utilization data between the Department and the Department’s contracted managed health care plans. This position resolves complex operation and/or data processing issues and monitors system performance; makes recommendations for enhancements; and review systems to ensure compliance with procedures, policies, or regulations. The SBA will assist, as needed, in information analysis support for the Department; work with the Department’s managed care plans and other technical staff to troubleshoot problems; work closely with the Department of Workforce Services (DWS), Department of Technology Services (DTS), division staff, other government agencies and managed care plans to ensure eligibility and managed care enrollment data is received and processed timely and accurately according to HIPAA, managed care contracts and other business needs.
The SBA resolves a variety of complex eligibility and enrollment issues and may perform a combination of the following tasks: develop, interpret and implement policies and procedures and ensure enforcement; ensure compliance with federal and state rules, regulations and mandates; monitor program and system effectiveness; communicate and coordinate with managed care plans; communicate system issues with other division staff; provide technical expertise; compile statistics, analyze data, and make recommendations. Must be able to communicate effectively, maintain relationships, and work independently as well as part of a team.
Preference may be given to those with experience with Medicaid/CHIP eligibility, managed care enrollment, managed care contracts, eREP, PRISM, Data Warehouse, COGNOS, SQL or database experience.
Note: as of July 1, 2021, State of Utah Employees must either reside in Utah or be in the process of relocating to within 30 days of their start date.
Why work for the Utah Department of Health and Human Services? In addition to the rich the State of Utah offers, the department offers:
For more information on the Utah Department of Health and Human Services, please click .
If offered this position, your employment will be contingent upon passing a background check and review. There will be no cost to you for this check. This check will include fingerprinting, which will be available at various DHHS locations for your convenience. Fingerprinting will be completed prior to your first day of employment. You may review the policy by clicking
Example of Duties
Typical Qualifications
Supplemental Information
Benefits:
The State of Utah offers eligible employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for a detailed information page: . To access a Total Compensation Calculator in Excel format click .
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