Health Care

Business Analyst Sr

Contract

Strategic Staffing Solutions

Senior Business Analyst

Location: Detroit, MI

Responsibilities:

  • Compliance Monitoring: Ensure agents comply with CMS regulations and guidelines for selling and enrolling Medicare Advantage plans.
  • Quality Assurance: Monitor and evaluate agent performance to ensure quality service and accurate information to potential beneficiaries.
  • Policy Interpretation: Interpret and communicate Medicare policies and guidelines.
  • Metric Tracking: Establish and track performance metrics to assess agent effectiveness and identify areas for improvement.
  • Regulatory Updates: Stay informed about changes in Medicare policies and regulations to ensure agents remain compliant.
  • Collaboration and Communication: Collaborate with cross-functional teams and communicate with stakeholders to ensure alignment and effectiveness in oversight.
  • Documentation and Reporting: Maintain accurate records of agent activities, compliance efforts, and performance for reporting purposes.
  • Process Improvement: Continuously identify and implement process improvements to enhance efficiency and effectiveness in oversight.
  • Legal and Ethical Adherence: Ensure that agencies and agents adhere to legal and ethical standards in their interactions with beneficiaries.
  • Risk Management: Identify and mitigate risks associated with agent activities to maintain compliance and protect the organization’s reputation.

Requirements:

  • Understanding of CMS regulations, policies and guidelines related to Medicare Advantage.
  • Ability to provide constructive feedback and facilitate effective communication between agencies and various stakeholders.
  • Excellent communication skills, both written and verbal, to effectively convey Medicare Advantage policies and guidelines to agencies, agents, and internal stakeholders.
  • Skilled in utilizing current industry standard PC applications and systems (e.g., Access, Excel, Word, Teams, and Outlook).

Job ID: JOB-233898
Publish Date: 08 Feb 2024

Tagged as: Business Analyst Sr