Engagement and Strategy Business Analyst III

Job Category: Administrative, HR, Business Professionals

Department: Provider Network Management

Location:

Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 8819

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Engagement and Strategy Business Analyst III is a critical thinker who is responsible for eliciting, analyzing, communicating, testing and verifying requirements for engagement (i.e. required and general communications; training; manuals; etc.) and strategy services delivered through, or coordinated by, the L.A. Care (LAC) Provider Network Management (PNM) organization. The Engagement and Strategy Business Analyst III will use strong organizational and communication skills to build and foster effective relationships to support the elicitation and communication of business requirements from and to leadership of LACs lines of business (Medi-Cal; Medicare; and Commercial). The Engagement and Strategy Business Analyst III is responsible for maintaining a subject matter expertise of the operational, reporting, and accrediting requirements for all lines of business (Medicaid, Medicare, and Commercial) and support his or her team in ensuring the LAC PNM organization is compliant.

Partnering with the business leaders from within PNM, the Engagement and Strategy Business Analyst III is responsible for coordinating reviews and preparing for internal and regulatory audits of the PNM organization, and its delegated provider groups; examining audit findings and responding to citied deficiencies; and, making recommendations for corrective actions and monitoring internal and external corrective action plans, as it pertains to engagement materials and update any strategies as necessary.

Duties

Elicits, documents, analyzes, communicates, tests and verifies requirements for engagement and strategy department responsibilities. Assesses the requirements of the organization with respect to its operations and functions for improved provider engagement. Reviews the LAC PNM organization, the LAC contracted Plan Partners, and LAC delegated entity policies, procedures, internal controls, and materials. Reviews transactions, source documents, disclosures, and outcomes for compliance with contractual, regulatory, and accrediting requirements, and LAC business policies. Conducts needs assessments and instructional analysis to ensure conformity with all engagement, training, and strategy objectives, and develop corresponding work plans and project schedules as needed. Conducts performance-based measurement assessments for objective evaluation of engagement and strategy processes in support of organizational and departmental strategy and engagement initiatives.

Designs and documents business process requirements for all related business, and operational systems critical to core business functions of engagement and strategy within LAC PNM. Researches and analyzes data in support of business functions, process knowledge, and systems requirements. Analyze the business processes in an organization for inefficiencies. Make recommendations for solutions or improvements that can be accomplished through new process or technology, or alternative uses of existing processes or technology. Track the LAC PNM organization, and the LAC contracted Plan Partners, and LAC delegated entity audit or other regulatory findings and ensure corrective action taken is appropriate and effective.

Responsible for conducting monitoring and oversight assessment activities to review the ongoing performance of processes and controls conducted and implemented within the PNM Engagement and Strategy department, and the LAC contracted Plan Partners; assesses these and other activities for compliance with contractual, regulatory, and accrediting requirements, and LAC business policies.

Develops, implements, and maintains engagement and strategy content reports, and technical procedures as required. Responsible for evaluating, updating, maintaining, and archiving all engagement and strategy criteria and versions, in accordance with department information retention requirements.

Education Required

Bachelor's Degree in Related Field

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Experience

Required:
At least 3-5 years responsible work experience in provider engagement specifically in communications, marketing, education or public relations and in managed care or health care industry.

Proven ability to work with a diverse group of people, including physicians, support staff, coworkers and management.

Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.

Skills

Required:
Expert in Microsoft Office applications.

Demonstration of both qualitative and quantitative analytical skills.

Demonstrated critical thinking and problem solving skills.

Strong written and verbal communication skills.

Strong elicitation and process documentation skills.

Strong organizational and communication skills to build and foster effective relationships.

Must possess a robust knowledge of all contracted PNM entities, including provider groups (PPG’s), Management Service Organizations (MSO’s), Vendors, Subcontractors, and directly contracted practitioners.

Strong critical thinking and problem solving skills to help ensure.

successful partnerships and department quality.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

L.A. Care offers a wide range of benefits including

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.