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Lead Clinical Business Analyst Nurse for WellMed

Lead Clinical Business Analyst Nurse for WellMed

Job Description

The Lead Clinical Business Analyst delivers solutions to complex business problems. The solutions will provide consideration to WellMed and Optum evolving business needs, which include the capacity and limitation of associated business systems, and evaluating system changes for downstream impact. This position oversees the development, specification and integration of strategic WellMed systems and will analyze business needs, document requirements, translate needs into functional and / or technical specifications, write and execute test cases and plans, and oversee testing and build processes.

Essential Job Functions

  • Defines project scope and objectives based on business unit needs combined with a thorough clinical understanding of enterprise business systems and industry requirements. 

  • Performs a major role in the development and implementation of major systems.  This role interfaces with multiple business units such as accounting / finance, claims, operations, physician clinics, customer service, executive management, and sales and marketing.

  • Serves as an expert resource regarding the alignment of enterprise system strategies with the business goals and strategic drivers.

  • Applies knowledge of managed care operating environment and underlying systems data to all major production systems used for delivery of services to internal and external clients.

  • Develops and maintains strong relationships with both internal customers and external vendors at the senior management and executive level in order to influence project teams and gain consensus on the selection of the most viable solutions. The position acts as a key team member to both IT and the assigned business unit.

  • Uses strong critical thinking skills along with managed care and physician office business knowledge to have insight and understanding of business concepts, tools and processes that are needed for making sound decisions in the contact of the company's business.

  • Manages system code set and rule configurations, quality assurance application testing to include:  creation of business requirements, validation of design to business requirements, writing test plans, conducting functional and performance testing to include application and system integration testing.

  • Tracks progress and notifies management of issues that require escalation, and assumes responsibility for resolving or coordinating the resolution of system and process issues.

  • Develops and maintains project plans, and manages specific tasks to ensure project success.

  • Collaborates on and oversees various projects as assigned that are cross-functional in nature.

  • Provides project task level supervision to Developers, Business System Analysts, and / or Sr. Business System Analysts on a project specific basis.

  • Performs all other related duties as assigned.

Job Requirements

  • Bachelor's of Science degree in Nursing or related field (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree).

  • Current Registered or Vocational Nurse License in applicable state.

  • Three years of experience working in a healthcare or clinical environment.

  • Five or more years experience in developing requirements and performing system analysis.

  • Five or more years experience of major systems implementation experience.

  • Experience with various system development lifecycles such as waterfall, RUP, and Agile methods.

  • Ability to communicate ideas and problem solutions.

  • Ability to effectively work with both internal and external clients.

  • Extensive knowledge of Health Care Industry and related business functions.

Preferred Education, Experience & Skills

  • Advanced degree in a related discipline preferred.

  • Five or more years experience in one or more of the following areas:  clinical systems design and delivery, database programming experience, HL7 integration, practice management system implementation and support, EMR system implementation and support, Claim adjudication system implementation and support, Care Management system implementation and support.

WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella.

WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services.  Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.

Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness.  We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors.  Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job Snapshot

Employment Type Full-Time
Job Type Finance, Insurance, General Business
Education 4 Year Degree
Experience Not Specified
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID UHG-556527
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Lead Clinical Business Analyst Nurse for WellMed

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