Business Analyst, Senior - Regulatory Medi-Cal

Job Description

Your Role

The Medi-Cal Program Support (MPS) team ensures sufficient and complete Medi-Cal operational documentation by reviewing and supporting development of business process documentation; development of regulatory data and files process documentation; and development of employee trainings. The Business Analyst will report to the Senior Manager of the Business Process Unit within MPS. In this role you will, conduct reviews to verify the adequacy and comprehensiveness of business process documents, ensuring they meet regulatory standards, contractual obligations, and business objectives. Additionally, you will assist in developing current state documents and provide oversight for the maintenance of operational process documentation.

Your Work

In this role, you will:

  • Conduct comprehensive reviews of operational documents, including policies and procedures, desk level procedures, processes, regulatory reports, and internal controls.
  • Work with business units on remediations and enhancement of Medi-Cal operational processes to ensure regulatory adherence and operational efficiency.
  • Assist operational areas with documenting current state processes.
  • Report out on status of operational process reviews, process documentation support, and other projects or initiatives.
  • Serve as a Medi-Cal subject matter expert and liaison to operational areas to provide support with regulatory research, new initiatives, strategies, and decisions.
  • Participate in cross-functional meetings to discuss operational issues, foster teamwork, and promote collaboration across stakeholders.

Your Knowledge and Experience

  • Requires a bachelor's degree or equivalent experience
  • Requires at least 5 years of prior relevant experience
  • Requires at least 3 years of healthcare experience
  • Requires at least 1 year of Medi-Cal regulatory and operational experience
  • Requires experience with documenting and reviewing process documents

Pay Range:

The pay range for this role is: $ 77990.00 to $ 116930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.


External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

 

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