Caresource

Service Integration Analyst II

Caresource$62K — $100K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • High School Diploma required; Bachelor's degree preferred
  • 2+ years of customer service experience in healthcare payer
  • Experience translating business requirements into technical specifications
  • Familiarity with quality/process methodologies (e.g., Six Sigma, LEAN) preferred
  • Proficient in Microsoft Office Suite and Dynamics 365; NICE CXOne experience preferred
  • Proven ability to utilize data for analysis and recommendations

Responsibilities

  • Manage multiple medium complexity projects with limited manager guidance
  • Act as Subject Matter Expert for assigned products, ensuring compliance with standards
  • Conduct data analysis and process mapping to identify improvement opportunities
  • Create process documentation, including SOPs and workflow diagrams
  • Collaborate with leadership to prioritize process improvement initiatives
  • Evaluate service change requests and liaise with stakeholders for optimal outcomes
  • Assist with process audits and communicate with regulators as needed

Benefits

  • Hybrid work environment; 2-3 days in office
  • Comprehensive total rewards package focusing on employee well-being
  • Opportunities for training and development
  • Access to performance-based bonuses
  • Flexible work location for candidates within a certain radius
Full Job Description
Job Summary:

The Service Process Analyst II identifies opportunities for improvement in Customer Care's business processes and recommends projects aimed at enhancing quality, reducing costs, and promoting automation and call reduction. This position collaborates with stakeholders to ensure alignment and successful implementation of new procedures, conducts process audits and root cause analyses, and serves as a subject matter expert for assigned markets/products.

Essential Functions:
  • Manage a minimum of three medium complexity projects concurrently under limited direction of a manager
  • Act as a Subject Matter Expert for assigned markets/products, ensuring that policies, processes, and training are compliant with contractual, regulatory, accreditation, and quality standards. Ensure seamless data integration and flow between systems.
  • Perform comprehensive data analysis and process mapping to identify obstacles, inefficiencies, and opportunities for automation or reduction of inbound volume/AHT.
  • Create comprehensive process documentation and guidelines, including standard operating procedures and workflow diagrams.
  • Partner with leaders and subject matter experts across CareSource to identify and prioritize process improvement opportunities aligned with organizational strategic goals.
  • Assess incoming service change requests and engage with stakeholders to discuss requirements and prioritize actions, ensuring optimal use of time and resources.
  • Assist with audits, conversations with regulators, and cross-functional conversations requiring a Customer Care subject matter expert.
  • Contribute content for Voice of the Customer report, Status Reports, and other communications to Senior Leadership.
  • Train new team members to orient them to departmental policies, procedures, and responsibilities.
  • Perform any other job-related instructions as requested


Education and Experience:
  • High School Diploma is required
  • Bachelor's degree or equivalent years of relevant work experience is preferred
  • Experience translating business requirements into technical specifications is required
  • Experience and expertise with quality or process methodologies (i.e. Six Sigma, LEAN, APQC, etc.) is preferred
  • Proven experience in utilizing data to inform and support recommendations is required.
  • A minimum of two (2) years of customer service experience related to healthcare payer dealing with both members and providers is required


Competencies, Knowledge and Skills:
  • Demonstrates a high level of accountability as it relates to ensuring Customer Care has all required processes and tools.
  • Proficient use of Microsoft products including Word, Excel, PowerPoint, Visio, SharePoint, and Dynamics 365 is required.
  • Experience with NICE CXOne is preferred.
  • Strong interpersonal, active listening and critical thinking skills
  • Ability to document and maintain system requirements including process flows is required
  • Ability to keep current on business processes/technologies through self-directed learning
  • Excellent written and verbal communication skills
  • Ability to develop, prioritize and accomplish goals


Licensure and Certification:
  • Six Sigma Green Belt and APQC Certification is preferred


Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • Hybrid Position; 2-3 days/week in Dayton office if home address is within 45 miles. Preferred days are Tuesday, Wednesday, & Thursday.
  • Ability to travel as required by the needs of the business.


Compensation Range:
$62,700.00 - $100,400.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):
Salary

Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business


This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.
#LI-KM1

Brand=CareSource

About Caresource

CareSource is a nonprofit health plan that provides managed care services to individuals and families in Ohio, Kentucky, Indiana, and West Virginia. The company was founded in 1989 and is headquartered in Dayton, Ohio. CareSource offers a variety of health insurance plans, including Medicaid, Medicare Advantage, and Marketplace plans. The company is committed to improving the health and well-being of its members and invests in programs and services that promote healthy living. CareSource is one of the largest Medicaid managed care plans in the United States.
Learn more about Caresource
Size
4,000 employees
Industry

Similar Jobs

More Jobs at Caresource

More Healthcare Jobs

Find similar Service Integration Analyst II jobs: