Senior Business Analyst – Remote

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Pinnacle Method Consulting
  • Finance
  • FullTime
  • Applications have closed

Pinnacle Method Consulting’s mission is to help job seekers reach their career peak by accessing top-tier opportunities. We are not a staffing firm or agency. Pinnacle Method does not hire for these roles—we systematically source and verify them from premier employers.

Employer Industry: Healthcare Services

Why Consider This Job Opportunity

  • Opportunity for career advancement and growth within the organization
  • Work remotely in a dynamic and autonomous environment
  • Competitive benefits and compensation package
  • Engaging with cross-organizational projects that influence health plan operations
  • Chance to utilize and enhance your expertise in claims operations and regulatory compliance

What To Expect (Job Responsibilities)

  • Communicate requirement interpretations and changes to health plans and various corporate functional areas to ensure alignment and approvals
  • Monitor regulatory sources to ensure updates are documented and aligned with operational processes
  • Identify changes to existing business processes and new opportunities for improvement
  • Provide updates to health plan partners, senior management, and stakeholders on project statuses
  • Collaborate with claims operations, IT, and product teams to ensure accurate reflection of claims requirements across systems

What Is Required (Qualifications)

  • At least 4 years of experience in a managed care organization, health insurance, or a related field
  • Knowledge of policy and government legislative review
  • Strong analytical and problem-solving skills
  • Familiarity with administration systems
  • Proficient in Office Product Suite, including Word, Excel, Outlook, and Teams

How To Stand Out (Preferred Qualifications)

  • Experience in project implementation
  • Knowledge of federal regulatory policy resources, including CMS and the ACA
  • Medical Coding certification

HealthcareServices #ClaimsOperations #RemoteWork #CareerOpportunity #RegulatoryCompliance

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