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Medicaid Operations Analyst

Job Ref: 64691
Category: Professional
Department: OPERATIONS EXCHANGE
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $70,000.00
Salary Range: $70,000.00 - $77,345.00

About NYC Health + Hospitals

MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. 

Position Overview
Reporting to the Director of Medicaid, the Medicaid Operations Analyst will play a critical role in supporting operational excellence and regulatory compliance across all Medicaid products. The analyst will provide analytical and project management support to the Director to ensure prompt follow-up and timely completion of projects.

Job Description

• Support the Director in providing oversight of Plan and vendor operations aligning outcomes to strategic goals & regulatory requirements.
• Support the development & management of operational dashboards to track operational effectiveness.
• Analyze & trend data to provide insights to Director & management on product operations including but not limited to membership, market trends & position, and claims.
• Provide project management support to ensure projects are completed on time & meet the needs of the organization including but not limited to: operational performance improvement initiatives, issue identification & resolution, regulatory changes, new product/program implementations, special projects.
• Proactively identify & escalate gaps, making recommendations to enhance current processes.
• Serve as a liaison between multiple stakeholders to ensure clear, consistent communications & that solutions meet product requirements.
• Support operational departments in developing workflows, issue logs, project plans as needed to meet project requirements.
• Assist in the development of policies & procedures & other operational documentation.
• Demonstrated ability in managing workplans & holding stakeholders accountable
• Other duties as required.

Minimum Qualifications

• Bachelor’s degree from an accredited college or university in an appropriate discipline required.
• Master’s degree in business, healthcare or public administration strongly preferred.
• A minimum of two years experience, preferably at a Health Plan with Medicaid Managed Care in a compliance/regulatory or project management role.
• Experience with managing projects and partnering with cross-functional teams.
• Excellent verbal and written communication skills
• Excellent analytical skills as demonstrated by significant ability to pull data and analyze complex data sets.
• Experience using reporting tools & software such as SQL, SAS, Tableau preferred. Facility with Excel required.

Professional Competencies
• Results-driven
• Systems orientation
• Process improvement
• Technical & analytical skills
• Customer focus
• Written/oral communication
• Resourcefulness
• Ability to work effectively in a fast-paced & constantly evolving environment