DaVita Business Analyst II in Las Vegas, Nevada

SUMMARY

The Business Analyst II reports to the Manager of the Central Business Unit (CBU) and performs moderate to complex tasks within our claims platform. This position may interface with system architects and corporate staff on benefit and contract updates, and system projects to support resolution of issues.

ESSENTIAL FUNCTIONS

• Responsible for quality and continuous improvement within the job scope.

• Responsible for all actions/responsibilities as described in company controlled documentation for

this position.

• Contributes to and supports the corporation's quality initiatives by planning, communicating and

encouraging team and individual contributions toward the corporation's quality improvement

efforts.

• Builds, audits and maintains health plan benefits to accurately manage, administer and ensure

compliance with health plan requirements.

• Builds, audits and maintains provider contracts and fee schedules to accurately manage and

administer claims payments.

• Assists in the documentation of cross functional meetings to facilitate configuration management

issues, approvals and changes.

• Assists in projects with moderately complex system modifications/updates.

• Interfaces with system architect to update system functions, such as but not limited to claims

queues, audit queues, medical referral rules, claims rules, new system implementations, system

upgrades and enhancements, and multiple system interfaces.

• Performs other work related duties and responsibilities as directed, assigned or requested.

EXPERIENCE REQUIREMENTS

• 5-8 years claims processing or system set-up experience, managed care preferred

EDUCATIONAL REQUIREMENTS

• High School Diploma or GED required, Some College preferred.

KNOWLEDGE, SKILLS, ABILITIES

• General knowledge of provider contracts, fee schedules and payment methodologies

• Knowledge of health plan benefit interpretation and set up

• Knowledge of current compliance legislation

• Strong interpersonal skills required

• Demonstrated proficiency in MS Excel and Word required

• Strong problem-solving skills required