Senior Business Systems Analyst Medicare Advantage Plan

UCLA Health System

Los Angeles, CA

JOB DETAILS
SALARY
$95,400–$208,300 Per Year
SKILLS
Acceptance Testing, Analysis Skills, Auditing, Business Intelligence, Business Model, Business Solutions, Computer Science, Content Management Systems (CMS), Cross-Functional, Customer Support/Service, Data Analysis, Data Management, Data Mart, Data Modeling, Data Science, Data Structures, Data Warehousing, Decision Support, Dimensional Modeling, Documentation, Enterprise Data Integration, Environmental Compliance, Health Plan, Health Science, Healthcare, Information Technology & Information Systems, Logic Testing, Medicare, Mentoring, Metrics, Microsoft Transact-SQL (T-SQL), National Committee for Quality Assurance (NCQA), Network Administration/Management, Operational Support, Operations Management, Operations Planning, Performance Analysis, Presentation/Verbal Skills, Process Development, Process Flow, Product Design, Quality Assurance, Regulations, Regulatory Compliance, Regulatory Reports, Regulatory Requirements, Reporting Dashboards, Reporting Skills, Risk, Root Cause Analysis, Salesforce.com, Statistics, Systems Analysis, T-1 / DS1, T-2 / DS2, Tableau, Team Player, Trend Analysis, Use Cases, Utilization Management, Validation Testing
LOCATION
Los Angeles, CA
POSTED
2 days ago

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n Senior Business Systems Analyst, Medicare Advantage Plann

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n General Informationn

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n Work Location: Los Angeles, CA, USAn

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n Onsite or Remoten

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n Flexible Hybridn

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n Work Schedulen

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n Monday-Friday, 8:00am - 5:00pm PSTn

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n Posted Daten

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n 06/11/2026n

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n Salary Range: $95400 - 208300 Annuallyn

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n Employment Typen

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n 2 - Staff: Careern

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n Durationn

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n Indefiniten

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n Job #n

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n 31146n

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n Primary Duties and Responsibilitiesn

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Reporting to the Associate Director of Delegated Oversight & Systems, the Senior Business Systems Analyst serves as technical authority responsible for delegated oversight reporting, business intelligence, data integration, and enterprise systems enablement. This role translates complex regulatory, operational, and business requirements into scalable data, reporting, workflow, and system solutions that support delegated oversight, audit readiness, performance accountability, and governance activities.

The role partners closely with Decision Support Services (DSS), OHIA, ISS, Compliance, Operations, Network Management, and Product teams to design, maintain, and optimize data marts, dashboards, reporting solutions, and business system workflows aligned with CMS, DMHC, NCQA, and organizational requirements. The incumbent must be independent judgment and advanced analytical expertise in managing complex reporting, data management, and system-related initiatives that support executive decision-making, operational performance monitoring, and enterprise scalability.

Key Responsibilities:

Regulatory Reporting & Oversight Analytics

xe2x80xa2tTranslate regulatory and operational requirements into scalable reporting, analytics, and performance monitoring solutions. Support regulatory reporting (UHMAP) and delegated entity oversight

xe2x80xa2tSupport CMS, DMHC, NCQA, and organizational reporting requirements through development and maintenance of regulatory and operational reports.

xe2x80xa2tAnalyze delegated entity performance, compliance, operational, and risk metrics through trend analysis, root-cause analysis, and performance monitoring methodologies.

xe2x80xa2tElicit, document, and translate business, regulatory, and operational requirements into functional specifications and technical requirements.

xe2x80xa2tSupport Salesforce enhancements, workflow design, reporting capabilities, and system optimization efforts supporting delegated oversight operations.

xe2x80xa2tDevelop process flows, use cases, data models, business rules, validation logic, and testing documentation.

xe2x80xa2tSupport User Acceptance Testing (UAT), quality assurance activities, and production validation efforts.

Salary Range: $95,400 - $208,300/annually

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n Job Qualificationsn

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Wexe2x80x99re seeking a detail-oriented analyst with:

Required:

xe2x80xa2tA Bachelorxe2x80x99s degree in Information Systems, Health Sciences, Data Analytics, Statistics, or related field, and/or equivalent combination of education and experience

xe2x80xa2t5 or more years of experience in business systems analysis, data analysis, or reporting experience supporting healthcare operations, health plans, or regulated environments

xe2x80xa2t5 or more years of experience translating business and regulatory requirements into technical specifications, data definitions, and reporting solutions

xe2x80xa2t5 or more years of experience working with healthcare data sources such as claims, encounters, membership, provider, utilization management or vendor data

xe2x80xa2t2-4 years of experience developing regulatory, compliance, or performance reporting (e.g. CMS, NCQA, DMHC, audit support)

xe2x80xa2tSQL or Data Analytics certification at hire or within reasonable time

xe2x80xa2tTableau, Power BI, or equivalent BI certification at hire or within reasonable time

xe2x80xa2tAdvanced SQL development and data querying skills (MS SQL Server preferred)

xe2x80xa2tStrong knowledge of healthcare data structures (claims, encounters, membership, providers)

xe2x80xa2tProficiency in BI and analytics tools (Tableau)

xe2x80xa2tAbility to translate business questions into technical solutions

xe2x80xa2tStrong analytical, problem-solving, and documentation skills

xe2x80xa2tEffective written and verbal communication across technical and non-technical audiences

Preferred:

xe2x80xa2tA Masterxe2x80x99s Degree in Computer or Data Science

xe2x80xa2t2-4 years of experience supporting data marts, data warehouses, or enterprise reporting environments in collaboration with analytics or IT teams

xe2x80xa2t1-3 years of experience working in cross-functional environments involving Compliance, Operations, Product, Analytics, or IT stakeholders

xe2x80xa2tHealthcare or Regulatory Reporting Certification (e.g. NCQA, CMS-related training)

xe2x80xa2tServe as technical mentor to experienced Business Systems Analysts and reporting professionals

xe2x80xa2tKnowledge of data warehouse concepts, dimensional modeling, and data governance

xe2x80xa2tExperience with CMS, NCQA, and regulatory healthcare measures

Note: Skills may be subject to test.

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As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

Current/former UC employees are subject to a personnel file review.

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About the Company

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UCLA Health System