Note: The job is a remote job and is open to candidates in USA. Moodys Northwest Consulting is recruiting for an unnamed client. The Senior Analyst supports implementation of contractual requirements by analyzing Medicaid contracts and translating them into clinical documentation updates, system changes, and business initiatives. The role also coordinates cross-functional projects and supports operational improvement and contractual compliance.

Responsibilities

• Coordinate and analyze end-to-end contractual requirements to identify operational and technological risks and support appropriate resolution
• Support multiple projects by maintaining and updating project documentation, managing project scope, adjusting schedules, prioritizing daily activities, and ensuring timely completion of project tasks and milestones
• Conduct complex business and systems process analyses to identify improvement opportunities and address operational challenges
• Support quality improvement and data management initiatives by ensuring data reliability and validity and developing process improvements based on actionable insights from key data
• Collaborate with cross-functional stakeholders, including operations, finance, marketing, and IT, to gather information, understand business needs, and establish alignment across teams
• Analyze Medicaid contracts, proposals, new business opportunities, rebids, expansions, and ad hoc updates to support the implementation of contractual requirements
• Work with clinical subject matter experts and leadership to translate contractual requirements into clinical documentation updates, system changes, and business implementation activities
• Develop an understanding of care management and utilization management processes, business strategies, services, and roadmaps to support compliant and effective implementation
• Apply analytical skills, industry knowledge, problem-solving capabilities, and sound judgment to support data-driven decision-making and strategic business initiatives
• Monitor implementation activities to help ensure contractual compliance, operational readiness, and alignment with business requirements

Skills

• 3–5 years of relevant experience in Care Management or Utilization Management within a Managed Care environment
• Experience reviewing, analyzing, and interpreting contractual requirements
• Demonstrated ability to conduct business and systems process analysis, identify operational challenges, and recommend process improvements
• Ability to support multiple projects, maintain documentation, manage scope and schedules, prioritize tasks, and track milestones
• Ability to support documentation and system changes aligned with contractual and business requirements
• Understanding of data reliability, data validity, process improvement, and the use of actionable insights to support business decisions
• Ability to work effectively with clinical subject matter experts, leadership, operations, finance, marketing, IT, and other stakeholders
• Demonstrated knowledge of problem-solving techniques and decision-making capabilities
• Strong analytical, organizational, and communication skills, with the ability to manage competing priorities and support timely project delivery
• Preferably involving Medicaid contracts, proposals, rebids, expansions, and contract updates
• A bachelor's degree
• Specialized training or a relevant professional qualification

Benefits

• Medical, vision, and dental benefits
• 100% remote – United States

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