Note: The job is a remote job and is open to candidates in USA. Health Net Health Plan of Oregon, Inc. is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. The role of Senior Business Technical Analyst focuses on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions while collaborating with various stakeholders to improve existing business systems.
Responsibilities
- Partners with business analysts, Risk Adjustment stakeholders, IT, and vendor teams to understand provided Medicare Advantage and Medicaid business requirements, translate them into technical specifications, and support process improvements through SAS solutions and future Snowflake capabilities
- Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment Prioritization and Encounter Risk Adjustment Chart Process workflows, with future Snowflake migration support
- Creates multi-user, real-time, robust database solutions by integrating complex healthcare datasets, including claims, enrollment, provider, pharmacy, clinical records, and vendor chart data
- Acts as a technical subject matter expert to convert provided business requirements into system analysis, technical design, advanced SAS/SQL programming, Snowflake modernization, and documentation of business applications/systems
- Modernizes legacy SAS ETL workflows into scalable Snowflake architecture using Snowflake SQL, Snowpark Python, and automated pipeline orchestration concepts such as Tasks and Streams
- Implements validation, reconciliation, and data quality frameworks to support CMS audit standards, state Medicaid requirements, and compliant Risk Adjustment encounter submissions
- Builds reusable SAS, SQL, and Snowflake data assets, modular code libraries, and technical documentation to reduce development time and support knowledge transfer across data and actuarial teams
- Develops ad-hoc reports to conduct data analysis and validation
- Confers with area/department to analyze current operational procedures and trends and identify problems
- Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals
- Research, evaluate and assess the financial impact of issues identified in data/processes
- Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems
- Creates multiuser, real-time, robust database solutions
- Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming and documentation of business applications/systems
- May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies
- Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow-up on identified issues
- Provides guidance and training to staff on process, procedures and issue resolution
- Complies with all policies and standards
Skills
- Requires a Bachelor's Degree in a related field
- Equivalent work experience in technical data analysis, conducting system analysis meetings, developing system design documents, developing project plans with achievable milestones and deadlines, and mediating different department demands to gain approvals on system scope and design
- Master's degree in a related field, i.e., Mathematics, Computer Science, etc may be considered in lieu of some of the required experience (not to exceed 2 years)
- 1+ year of experience in Healthcare
- 4+ years of experience in relevant programming to include SAS, SQL, Snowflake
- Experience with Medicare Advantage, Medicaid, Risk Adjustment, encounter submissions, claims, enrollment, provider, pharmacy, clinical, and vendor chart data
- Experience modernizing SAS ETL workflows into Snowflake using Snowflake SQL, Snowpark Python, and automated pipeline orchestration
- 3+ years of experience in related business analysis
- 1+ year of experience in ASP/ASP.NET
- Preferred SAS Certified Professional or SAS Certification
- Preferred SnowPro Certification
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- A flexible approach to work with remote, hybrid, field or office work schedules
- Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Company Overview