Health Insurance Analyst II

Company: Innova
Location: Birmingham
Posted on: April 23, 2025

Job Description:

BASIC FUNCTIONS: The Analyst II will be responsible for supporting and developing the quality improvement, risk adjustment and/or plan performance processes. This includes monitoring and reporting of quality, risk and/or performance indicators, identification of opportunities for improvement, conducting qualitative barrier analysis, collaborating with business areas to identify strategies for improvement and monitoring impact of initiatives. This position will monitor outcomes of key indicators including health status, health outcomes, member experience and operational metrics and have an in-depth knowledge of regulatory requirements. The incumbent will work collaboratively with the internal team to support research and analysis and incorporate policies and practices to ensure execution of a sound program to maintain integrity of internal procedures. The incumbent establishes and maintains partnerships with business areas and key personnel.

Remember to check your CV before applying Also, ensure you read through all the requirements related to this role.

PRIMARY RESPONSIBILITIES: Participate in enterprise-wide discussions and create work plans to accomplish established goals Utilize quality management process Monitor, analyze and report results of key quality and risk indicators Create positive, professional relationships with both internal and external customers Develop and disseminate dashboards within established timelines Communicate, educate, and collaborate on quality, risk and association regulations Collaborate with both internal and external customers Proactively research industry standards and best practices Participate in quality, risk and performance-initiated workgroups Consistently provide visibility into quality and risk projects and report progress to management Identify, monitor and initiate interventions in conjunction with business partners Handles multiple priorities and meets aggressive timelines

SUMMARY OF QUALIFICATIONS
Minimum of 3 years of experience in areas such as the healthcare field, quality improvement strategies, regulations related to quality, project management, and/or methods for data analysis techniques and interpretation Experience with project management and continuous improvement, along with organizational and analytical skills in order to independently identify and evaluate opportunities for improvement related to Key Quality Indicators (KQIs) Provide support on complex project scopes and assist in the creation of work plans to achieve the objectives of projects Strong communication skills, both orally and written, along with positive collaboration and excellent interpersonal skills Experience handling day to day decisions with minimal guidance Experience presenting data or information for the purposes of proposal or decision making Experience developing objectives, setting goals and facilitating plans to achieve desired results Experience working with management to determine priorities and planning that support direction of a division Proficient in Microsoft Word, Excel and Power Point In office 2 days Innova Solutions is immediately hiring is immediately hiring for a Health Insurance Analyst

Location: Birmingham, AL
Employment Type: Hybrid 2 days in office/ 3 days remote
Work Hours: Monday to Friday, 8:00 AM - 5:00 PM

The Analyst II will be responsible for supporting and developing the quality improvement, risk adjustment and/or plan performance processes. This includes monitoring and reporting of quality, risk and/or performance indicators, identification of opportunities for improvement, conducting qualitative barrier analysis, collaborating with business areas to identify strategies for improvement and monitoring impact of initiatives. This position will monitor outcomes of key indicators including health status, health outcomes, member experience and operational metrics and have an in-depth knowledge of regulatory requirements. The incumbent will work collaboratively with the internal team to support research and analysis and incorporate policies and practices to ensure execution of a sound program to maintain integrity of internal procedures. The incumbent establishes and maintains partnerships with business areas and key personnel.

PRIMARY RESPONSIBILITIES:
--- Participate in enterprise-wide discussions and create work plans to accomplish established goals
--- Utilize quality management process
--- Monitor, analyze and report results of key quality and risk indicators
--- Create positive, professional relationships with both internal and external customers
--- Develop and disseminate dashboards within established timelines
--- Communicate, educate, and collaborate on quality, risk and association regulations
--- Collaborate with both internal and external customers
--- Proactively research industry standards and best practices
--- Participate in quality, risk and performance-initiated workgroups
--- Consistently provide visibility into quality and risk projects and report progress to management
--- Identify, monitor and initiate interventions in conjunction with business partners
--- Handles multiple priorities and meets aggressive timelines

SUMMARY OF QUALIFICATIONS
--- Minimum of 3 years of experience in areas such as the healthcare field, quality improvement strategies, regulations related to quality, project management, and/or methods for data analysis techniques and interpretation
--- Experience with project management and continuous improvement, along with organizational and analytical skills in order to independently identify and evaluate opportunities for improvement related to Key Quality Indicators (KQIs)
--- Provide support on complex project scopes and assist in the creation of work plans to achieve the objectives of projects
--- Strong communication skills, both orally and written, along with positive collaboration and excellent interpersonal skills
--- Experience handling day to day decisions with minimal guidance
--- Experience presenting data or information for the purposes of proposal or decision making
--- Experience developing objectives, setting goals and facilitating plans to achieve desired results
--- Experience working with management to determine priorities and planning that support direction of a division
--- Proficient in Microsoft Word, Excel and Power Point
--- In office 2 days

PAY RANGE AND BENEFITS:
Pay Rate*: $90,000 - 100, 000 Total Comp
*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:
--- One of Largest IT Consulting Staffing firms in the USA - Recognized as #4 by Staffing Industry Analysts (SIA 2022)
--- ClearlyRated - Client Diamond Award Winner (2020)
--- One of the Largest Certified MBE Companies in the NMSDC Network (2022)
--- Advanced Tier Services partner with AWS and Gold with MS
Website: https://www.innovasolutions.com/

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. - 1324b.

Keywords: Innova, Decatur , Health Insurance Analyst II, Healthcare , Birmingham, Alabama