Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

JOB SUMMARY: The Healthcare Business Analyst I utilizes and evaluates claims, authorization, member and provider data to assist the development, tracking and monitoring of healthcare metrics. This position displays proficiency with Microsoft Excel, MS Access, SQL.

MINIMUM QUALIFICATIONS:

Education/Specialized Training/Licensure:

• Bachelor's Degree required, Advanced Degree preferred

Work Experience (Years and Area):

• 1 year experience with SQL query writing.
• 1 years experience with reporting tools (e.g., MS Excel, Access, SQL Reporting Services, Power BI or similar, etc.)
• Preferred: Knowledge of healthcare coding (ICD, CPT, DRG) and experience developing actionable reporting using key metrics communicated in an easy to understand manner.

Software Operated: Microsoft Office (Word, Excel, Outlook)

SPECIAL REQUIREMENTS:
Communication Skills:
Above Average Verbal (Heavy Public Contact)
Writing/composing, Correspondence/Reports

Other Skills:
Analytical
Mathematics
Medical Terminology
Research
Statistical
PC
MS Word
MS Excel
MS Access

Advanced Education:
Bachelor's Degree Major: Computer Science, Healthcare Administration, or Related Field.
Master's Degree Major: Masters Degree in above fields preferred.

Work Schedule: Flexible

RESPONSIBLE TO:
Supervisor/Manager

EMPLOYEE SUPERVISED:
None