Business Analyst Job at Robert Half

Job Description

Are you a healthcare data enthusiast who thrives at the intersection of operational compliance, financial analytics, and clinical workflows? We are seeking a high-caliber Business Analyst to join our dynamic team supporting the Coding and Comprehensive Health Assessment Programs (CHAPs) departments. You will serve as the strategic analytical engine driving compliance, data integrity, and operational efficiencies across our Medicare Advantage and Risk Adjustment workflows. In this position, you will directly manipulate large-scale healthcare data sets to identify trends, mitigate compliance risks with CMS regulations, optimize coder workflows, and uncover opportunities that directly impact clinical operations and accurate market reimbursement models.

Job Responsibility

Complete routine and complex data analysis projects, process mapping, and workflow modeling
Identify variances, performance trends, and anomalies within Risk Adjustment and clinical documentation datasets
Conduct end-to-end business process assessments across coding operations and CHAPs workflows
Formulate data-driven strategies, tactics, and solutions to eliminate process bottlenecks
Prepare, maintain, and expand a dynamic library of key performance measures, dashboards, and automated operational reports
Manage recurring scheduled reports while balancing concurrent ad hoc project requests
Act as an embedded analytical partner to Department Heads, Clinical Leaders, and Matrixed Operations teams to drive strategic market initiatives to completion
Ensure absolute data integrity and regulatory alignment with CMS guidelines
Protect and disclose patients’ protected health information (PHI) in strict compliance with HIPAA standards

Requirements

Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Health Informatics, or a closely related field (or equivalent specialized work experience)
Minimum of 2+ years of hands-on data analytics experience within the healthcare field
Strong operational familiarity with Medicare Advantage, Managed Care, Capitation models, and medical group structures (clinical operations, care management)
A self-starter with an elite sense of personal accountability and a passion for owning projects in a fast-paced, high-energy environment
Expert-level spreadsheet management and financial/operational modeling
Must easily manipulate large volumes of data, build advanced pivot tables, and use complex formulas (INDEX/MATCH, XLOOKUP, nested IF statements, etc.)
Expert proficiency in SQL or MS Access to query, filter, and extract data from data warehouses or Electronic Health Records (EHR)
Hands-on experience utilizing Microsoft Visio to map out complex, multi-layered workflows, swimlane diagrams, and operational bottlenecks

Nice to have

Experience writing advanced macros
Hierarchical Condition Categories (HCC) & Risk Adjustment Factor (RAF) scoring models
Familiarity with RAPS (Risk Adjustment Processing System) or EDPS (Encounter Data Processing System) CMS data submissions
Experience metrics-tracking chart auditing workflows or coder productivity/error rates
Familiarity with data visualization platforms (Power BI or Tableau)

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan

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