Job description
Overview
The Program Analyst role is responsible for monitoring, inspecting, and proposing measures to correct or improve our organization’s program offering to meet established quality standards and customer expectations. Responsibilities include developing the processes and tools to monitor results of the program, implement a framework to evaluate the quality of information being presented, actively participating in the identification and resolution of issues and corrections, and implementing a structure to reporting on key program performance metrics. The Program Analyst is part of the SmartShopper Team, working closely with the SmartShopper Program Director and across other teams, to implement continuous improvement efforts to deliver higher savings performance and enhanced consumer experiences.
Essential Duties and Functions
- Develop monitoring program and processes, with accompanying reporting, to effectively assess ongoing SmartShopper program performance, leading to increased claim savings and consumer satisfaction measures.
- Ensures results provided to consumers comply with program design and customer expectations.
- Collaborates with SMEs across teams to help diagnose root-cause issues and implement recommended solutions to support daily operations and ongoing quality improvement initiatives.
- Working independently, and under the guidance of the Program Director, builds tools and processes to identify potential issues and areas for improvement. Following the approved issues process, is able to diagnose and escalate issues that could impair program performance. Is able to promptly and effectively communicate high risk findings and overall trends.
- Collaborate across our business unit to define workplace performance challenges and opportunities.
- Work with department leaders and peers to develop and implement ongoing process improvements. Takes initiative to recommend changes, with supporting impact and data, to effectively gain support for program changes.
- Design, development, delivery, and ongoing measurement of program improvement initiatives. Develops sustainable, repeatable, and quantifiable business process improvements.
- Active participant in strategic planning and team activities to deliver strategic initiatives and program enhancements.
- Thoroughly documents findings and helps educate others in the business about impacts to overall performance.
Experience, Qualifications, Knowledge, and Skills
- Combination of 5+ years and experiences in a program or operations role is preferred
- 5+ years and experience in a quality assurance role is required.
- Advanced knowledge and experiences of the following:
- Define, design, develop and implement business processes to capture baseline measurements and outcomes.
- Identify areas for improvement within the business process, based on data and analysis. Ability to implement and measure short- and long-term impacts of changes implemented.
- Extremely proficient in structured data sets using data management tools such as Power BI, Salesforce, SQL, and Excel
- Report on quality assurance findings for operational effectiveness.
- Medical terminology, healthcare literacy, and ability to interpret complex medical procedure information.
- Strong aptitude working with different personalities, cultures, and ethnicities.
- Exceptional analytical thinking, and critical thinking skills are required.
- Must be a motivated self-starter and able to work independently without supervision.
- Must adapt well to change and successfully adjust priorities as needed.
- Ability to multitask, set priorities, and manage timelines effectively.
- Ability to travel periodically up to 25%.
- Demonstrates expertise working in a secure, digital environment with highly confidential data.
Physical Demands
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Sedentary work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently to lift, carry, push, pull or otherwise move objects in daily work use (laptop, monitors, et. al). Sedentary work involves sitting most of the time. Use of keyboards (typing) and exposure to computer screens occurs daily. Pleasant work environment in office locations with occasional noise or dust.
- While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands; reach with hands and arms; think; and talk or hear (multi-channel, two-way communication during work hours is required).
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Zelis provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.
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