Clinical Business Analyst
Posted on: April 19, 2019
Works collaboratively with various levels of clinical staff and
Information Systems staff to clarify needs, prioritize requests,
and recommend workflow enhancements. Responsible for evaluating and
documenting clinical processes, including step actions and
workflows to construct and enhance the clinical model of care.
REPORTS TO: MANAGER, OF CLINICAL SYSTEMS DEPARTMENT: HEALTH
SERVICES INFORMATICS POSITION LOCATION: TAMPA, FL 33634
- Serves as a clinical resource for an assigned work stream unit
- Intake, UM, CM, DM, Reporting or Appeals.
- Assists in the documentation and gathering of detailed
requirements and workflow processes and analysis.
- Reviews current workflow and lead recommendations and defines
requirements to build processes and forms needed to support the
business in the new system.
- Recommends and implements software based on best
- Analyzes customer needs and identify system and procedural
solutions to enhance the clinical practices.
- Identifies opportunities to leverage technologies in areas that
improve and promote the clinical agenda.
- Performs gap analysis.
- Identifies needed process changes to ensure compliance with the
use of technology to optimize care delivery processes and
effectively communicate patient care activities.
- Performs application testing and creates test scripts -
- Develops and creates test plans for SIT and UAT.
- Performs UAT Testing.
- Works with IT to resolve update issues.
- Communicates with internal partners to obtain sign-offs.
- Ensures updates are tested and applied on a timely basis.
- Provides documentation and training as needed.
- Insures technology meets Compliance and Regulatory
- Performs other duties as assigned. Candidate Education:
- Bachelor's Degree in a related field, preferably health
sciences or equivalent work experience which is 5 years of relevant
work experience required without a Bachelors degree is required
- 3 years of experience in a managed care organization using
clinical skills is required
- System implementation experience is required
- 1 year of experience in Utilization Management and/or Care
Management is preferred Candidate Skills:
- Demonstrated written communication skills
- Demonstrated interpersonal/verbal communication skills
- Ability to effectively present information and respond to
questions from peers and management
- Ability to analyze and interpret financial data in order to
coordinate the preparation of financial records
- Ability to work as part of a team
- Ability to work independently
- Ability to work in a fast paced environment with changing
- Demonstrated organizational skills
- Ability to remain calm under pressure
- Ability to work overtime as required Licenses and
A license in one of the following is required:
- LPN or RN is required Technical Skills:
- Microsoft Outlook is required
- Microsoft Word is required
- Microsoft PowerPoint is required
- Microsoft Excel is required
- Microsoft Access is required
- Microsoft Visio is required About usHeadquartered in Tampa,
Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on
providing government-sponsored managed care services to families,
children, seniors and individuals with complex medical needs
primarily through Medicaid, Medicare Advantage and Medicare
Prescription Drug Plans, as well as individuals in the Health
Insurance Marketplace. WellCare serves approximately 5.5 million
members nationwide as of September 30, 2018. WellCare is a Fortune
500 company that employs nearly 12,000 associates across the
country and was ranked a "World's Most Admired Company" in 2018 by
Fortune magazine. For more information about WellCare, please visit
the company's website at . EOE: All qualified applicants shall
receive consideration for employment without regard to race, color,
religion, creed, age, sex, pregnancy, veteran status, marital
status, sexual orientation, gender identity or expression, national
origin, ancestry, disability, genetic information, childbirth or
related medical condition or other legally protected basis
protected by applicable federal or state law except where a bona
fide occupational qualification applies. Comprehensive Health
Management, Inc. is an equal opportunity employer, M/F/D/V/SO.
Keywords: Wellcare, Tampa , Clinical Business Analyst, Professions , Tampa, Florida
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