Business Analyst - Health Plan

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Company: TotalMed

Location: Minneapolis, MN 55407

Description:

Business Analyst-Health Plan

Job ID #1806849

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About this Role

Job details

$45.31 / hour

Minneapolis, Minnesota

Profession: Business Analyst

Facility Type: ???

Specialty: Health Plan

Division: MedFi

Start Date: 07/01/2025

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Responsibilities

Assist with development and validation of project member demographic files for prospective medical record retrieval and abstraction project.

Over-read of vendor-abstracted medical records for HEDIS measures.

Research claims systems for alternate chase opportunities and make outbound phone calls to provider/practitioner offices.

Liaise with priority provider groups (i.e., provider incentive or value-based care [VBC] program participants) regarding chart retrieval as needed

Required Qualifications

The candidate must be technically savvy and must be able to work without distraction.

This is a high production environment, and candidates must adhere to measured productivity requirements.

HEDIS experience with the following measures, overread experience preferred: BCS, CBP, CCS, CIS, EED, KED, GSD, IMA, PPC and WCC

Three plus years HEDIS / medical record review / MRRV experience

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