Lumeris Business Systems Analyst in St. Louis, Missouri
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Business Systems Analyst
The Business Systems Analyst performs moderate to complex configuration activities and should demonstrate an expertise in the core claims adjudication system and all interface applications, both customized and packaged. This individual should have knowledge and understanding of the configuration of business rules that support reimbursement policies and methodologies of the organization. The analyst will coordinate and maintain assigned Business Application systems for the program and play a key role in the configuration and implementation of new markets and products. The analyst should consider interdepartmental impact when recommending and implementing solutions. Responsibilities include but are not limited to the maintenance of the core claims adjudication system; system configuration for provider/hospital contracts, benefit plans, fee schedule loads; claim analysis, testing, documentation and reporting. He or she may be the primary contact for one or more claims system interface applications and is expected to provide a moderate to high level of expertise with matters relating to this interface and its functionality.
In addition the Business Analyst will be responsible for managing configuration projects, coaching junior analysts and for preparing performance reports for the department.
Role and Responsibilities
Maintain and support the Business Applications department as assigned, including complex configuration, stand-alone software systems, core claims system functionality and reporting
Perform data analysis and draw business conclusion for decision making
Assist in the creation of complex design documents through the assessment of requirements
Evaluate current configuration and recommend improvements
Assist with projects for the program that may involve other departments and/or personnel
Initiates root cause analysis and serve as a resource to others for troubleshooting configuration issues
Assist with the development and maintenance of departmental performance reports, metrics and dashboards
Experience, Qualifications, and Education
Bachelor’s Degree in Computer Science, Information Systems, Business or related technical field, preferred
Ability to retrieve and analyze data using Microsoft Access, Excel and SQL
Strong knowledge of software implementation / development life cycle
Strong verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence, present and partner across the organization
Proven ability to work independently while managing multiple tasks and priorities and demonstrated ability to independently lead multi-functional projects
Functional understanding of health care claim data sets such as ICD-9/10, CPT and HCPC
1-3 years in analytical roles preferred
3+ years business experience possibly including Claims or Healthcare related experience (preferably Medicaid Managed Care or Medicare)
1-3 years experience working in Information Systems (software installation, system configuration, SQL/Oracle platforms)
1-2 years experience writing TSQL or SQL queries
1-2 years MS SQL server experience including: SQL Server Analysis Services, SQL Server Reporting Services or SQL Server Integration Services
Lumeris is an EEO/AA employer M/F/V/D.
St. Louis, MO
XL - FT
Join Our Growing Team!
Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.
Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.
In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!
Why Join Lumeris?
At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.