Qureos Mentor

Independent Living Systems, llc

<div>We are seeking a Business Analyst (Analytics &amp; Actuarial Services) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Business Analyst (Analytics &amp; Actuarial Services) plays a critical role in bridging the gap between business needs and data and analytic solutions. This position is responsible for thoroughly analyzing current regulatory reporting requirements, business and data processes, identifying areas for improvement, and defining clear reporting requirements to support regulatory reporting related projects. As a Business Analyst, you will be responsible for authoring reporting and data requirements, identifying gaps, and designing analytical solutions to improve and proactively address compliance and proactive monitoring of regulatory reporting requirement and related processes. Your end goal will be to ensure that regulatory reporting operates efficiently and effectively. You will work closely with stakeholders to gather business requirements, create process maps, and facilitate process improvements.
Minimum Qualifications:<ul><li>
Bachelor&rsquo;s degree in Business/Health/Public Administration or related field</li><li>
2+ years of experience as business analyst in healthcare or regulatory settings</li><li>
Experience in gathering business requirements, process mapping, and design of data solutions</li><li>
Proficiency in data analysis tools such as SQL, Excel</li><li>
Strong analytical thinking and a proactive approach to problem-solving, and attentiveness to detail</li><li>
Excellent communication skills with the ability to convey complex information clearly to diverse audiences.</li><li>
Relevant experience may substitute for the educational requirement on a year-for-year basis.</li></ul>
Preferred Qualifications:<ul><li>
Master's degree in Business/Health/Public Administration or related field</li><li>
Experience with data visualization tools such as Tableau or Power BI.</li><li>
Experience in Regulatory reporting</li><li>
Knowledge of regulatory requirements and compliance standards in the insurance industry.</li></ul>
Responsibilities:<ul><li>
Analyze business requirements and identify gaps to provide analytical solutions</li><li>
Collaborate with cross-functional teams to implement process improvements</li><li>
Gather and document business requirements, translating them into technical specifications for analytics projects.</li><li>
Communicate complex analytical findings and insights to non-technical stakeholders through reports and presentation</li><li>
Support data validation and QA</li><li>
Monitor and evaluate the effectiveness of implemented solutions and recommend adjustments as necessary.</li><li>
Work cross-functionally with IT, finance, and operations teams to ensure alignment of analytics initiatives with business objectives.</li></ul></div>

Business Analyst (Analytics & Actuarial)

<div>We are seeking a Senior Financial Analyst (Analytics &amp; Actuarial Services) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Senior Financial Analyst (Analytics &amp; Actuarial Services) plays a critical role in driving data-driven financial decision-making within the organization. This position is responsible for conducting in-depth financial analysis, forecasting, and budgeting to support operational and strategic initiatives. The role requires collaboration with cross-functional teams to interpret complex financial data and translate it into actionable insights that enhance organizational performance. The Senior Financial Analyst will also monitor key financial metrics, identify trends, and provide recommendations to optimize resource allocation and cost management.
Minimum Qualifications:<ul><li>
Bachelor&rsquo;s degree in Finance, Economics, Actuarial Science, Mathematics, or a related field.</li><li>
5+ years of experience in financial analysis, preferably within the healthcare or social assistance industry.</li><li>
Strong proficiency in financial modeling forecasting, and budgeting techniques.</li><li>
Advanced knowledge of Microsoft Excel and financial software systems.</li><li>
Excellent analytical, problem-solving, and communication skills.</li><li>
Relevant experience may substitute for educational requirement on a year-for-year basis.</li></ul>
Preferred Qualifications:<ul><li>
Master&rsquo;s degree in Finance, Business Administration, or a related discipline.</li><li>
Familiarity with data visualization tools like Power BI or Tableau.</li><li>
Professional actuarial credentials (e.g., ASA, ACAS, or equivalent)..</li></ul>
Responsibilities:<ul><li>
Develop, analyze, and interpret financial reports, forecasts, and budgets to support management decision-making.</li><li>
Collaborate with all company departments to gather claims, financial, and other data and understand operational impacts.</li><li>
Monitor financial performance by measuring and analyzing results, initiating corrective actions, and minimizing the impact of variances.</li><li>
Prepare detailed financial models and scenario analyses to evaluate potential investments, cost-saving initiatives, and strategic projects.</li><li>
Present financial insights and recommendations to senior leadership and stakeholders to influence business strategy.</li><li>
Ensure compliance with healthcare financial regulations and reporting standards.</li><li>
Support the annual budgeting process and periodic financial reviews with comprehensive data analysis.</li><li>
Identify opportunities for process improvements and automation within financial reporting and analysis.</li></ul></div>

Sr Financial Analyst (Analytics & Actuarial)

<div>We are seeking a Senior Financial Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Senior Financial Analyst plays a critical role in driving the financial health and strategic decision-making of the organization. This position is responsible for conducting in-depth financial analysis, forecasting, and budgeting to support operational and strategic initiatives. The role requires collaboration with cross-functional teams to interpret complex financial data and translate it into actionable insights that enhance organizational performance. The Senior Financial Analyst will also monitor key financial metrics, identify trends, and provide recommendations to optimize resource allocation and cost management. .
Minimum Qualifications:<ul><li>
Bachelor&rsquo;s degree in Finance, Accounting, Economics, or a related field.</li><li>
At least 5 years of experience in financial analysis, preferably within the Medicaid and Medicare managed care industry.</li><li>
Strong proficiency in financial modeling, forecasting, and budgeting techniques.</li><li>
Advanced knowledge of Microsoft Excel and financial software systems.</li><li>
Excellent analytical, problem-solving, and communication skills.</li><li>
Relevant experience may substitute for educational requirement on a year-for-year basis.</li></ul>
Preferred Qualifications:<ul><li>
Master&rsquo;s degree in Finance, Business Administration, or a related discipline.</li><li>
Professional certification such as CFA, CPA, or CMA.</li><li>
Familiarity with enterprise resource planning (ERP) systems and data visualization tools like Power BI or Tableau.</li></ul>
Responsibilities:<ul><li>
Assist in monthly and year-end closing process, including analyzing financial data.</li><li>
Prepare month-end and quarterly reporting of consolidated financial statements, including but not limited to JE&rsquo;s and regulatory reporting</li><li>
Develop and facilitate the annual budgeting process.</li><li>
Monitor financial performance against budget, initiating corrective actions, and minimizing the impact of variances.</li><li>
Collaborate with all company departments to gather financial data and understand operational impacts.</li><li>
Prepare detailed financial models and scenario analyses to evaluate potential investments, cost-saving initiatives, and strategic projects.</li><li>
Present financial insights and recommendations to senior leadership and stakeholders to influence business strategy.</li><li>
Ensure compliance with healthcare financial regulations and reporting standards.</li><li>
Identify opportunities for process improvements and automation within financial reporting and analysis.</li></ul></div>

Senior Financial Analyst

<div>We are seeking a Senior Business Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Senior Business Analyst in Health Care Services plays a pivotal role in bridging the gap between clinical operations and technology solutions to enhance member care and organizational efficiency. This position is responsible for analyzing complex business processes, identifying areas for improvement, and designing effective strategies that align with healthcare regulations and standards. The role requires collaboration with cross-functional teams including clinical staff, IT professionals, and management to gather requirements and translate them into actionable project plans. The Senior Business Analyst will lead initiatives that drive data-driven decision-making and support the implementation of innovative healthcare solutions. Ultimately, this role ensures that business objectives are met while maintaining compliance and improving overall service delivery within the healthcare environment.
Minimum Qualifications:<ul><li>
Associate's degree in Business Administration, Health Informatics, or a related field.</li><li>
At least 4 years of experience as a Business Analyst within the healthcare industry.</li><li>
Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies (i.e. Per Diem, PPS, FFS, APG, Capitation, etc.) required.</li><li>
Must possess good understanding of claim adjudication process including ICD, CPT, HCPCS</li><li>
Strong proficiency in business analysis tools and methodologies, including requirements gathering and process mapping.</li><li>
Relevant experience may substitute for the educational requirement on a year-for-year basis.</li></ul>
Preferred Qualifications:<ul><li>
Bachelor's degree in Health Administration, Public Health, or a related discipline.</li><li>
Certification such as Certified Business Analysis Professional (CBAP) or Certified Healthcare Business Analyst (CHBA).</li><li>
Experience with Electronic Health Record (EHR) systems and healthcare data analytics platforms.</li><li>
Knowledge of healthcare quality improvement frameworks and member safety standards.</li><li>
Experience working in agile project environments.</li></ul>
Responsibilities:<ul><li>
Maintain data integrity of provider set-ups and reimbursement configurations, including timely updates and troubleshooting.</li><li>
Load and implement practitioner, hospital, and ancillary contracts into the claims system, including amendments and claims testing.</li><li>
Program and maintain pricing setups based on contract specifications across various care settings (e.g., inpatient, outpatient, ER).</li><li>
Participate in client implementations, conversions, and internal/external meetings to support operational needs.</li><li>
Create documentation for workflows and policies and mentor staff on complex contract configurations.</li></ul></div>

Senior Business Analyst

Join Independent Living Systems, llc and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Independent Living Systems, llc

About Company

Business Analyst (Analytics & Actuarial)

Sr Financial Analyst (Analytics & Actuarial)

Senior Financial Analyst

Senior Business Analyst