On-Site - Business Operations Associate at EveryAge – Lexington, North Carolina

Carolina Senior Care Is Hiring!

Join the dynamic team at Carolina Senior Care, a leading non-profit provider of PACE services. Located in Lexington, NC, Carolina Senior Care is committed to enriching the lives of seniors with compassion and excellence. Be part of a mission-driven organization that values innovation, community, and the well-being of our elders. Your role will be pivotal in delivering exceptional care and support, ensuring our participants live their best lives with dignity and joy. Join Us today!

Business Data Analyst - Full Time - On-site

Position Summary:

Under the supervision of the Business Office team lead, the Business Analyst generates operational reports, collects operation metrics, and analyzes all available data. Coordinates health plan data communication in compliance with CMS, DMA, and DSS regulations. The Business Analyst is also responsible for all aspects of the contract process for vendors and providers, including the credentialing process.

Essential Duties and Responsibilities:

1. Knowledgeable of Medicare, Medicaid, and insurance billing.

2. Responsible for CMS, DMA, and DSS data reporting requirements for Carolina SeniorCare. Performs RAPS, PDE, and Encounter data reporting for all EveryAge PACE Organizations.

3. Performs data collection, data analysis, and prepares informational presentations.

4. Measures and analyzes operation efficiency and financial performance of EveryAge PACE Organizations.

5. Synthesizes financial information and utilization reports.

6. Manages enrollment and disenrollment process.

7. Prepares and submits monthly data to CMS, DMA, and other required entities.

8. Participates in community committees as representative of EveryAge PACE communities as appropriate.

9. Practices Universal precautions and follow appropriate Infection Control procedures.

10. Maintains a safe working environment. Follows EveryAge PACE Policies and Procedures and OSHA safety guidelines.

11. Protects privacy and maintain confidentiality of all company procedures, results, and information about employees, participants, clients, or families.

12. Participates in continuing education classes and any required staff and training meetings.

13. Initiates and facilitates the contracting paperwork for vendors and providers. Tracks and monitors the contracting process through completion.

14. Maintains all provider and vendor contracts, updating with all required Centers for Medicare and Medicaid Services' criteria and documents for all service providers.

15. Under the direction of the Business Office Team lead, initiates, completes, and updates the credentialing process for all contracted providers and services. Maintains and updates the vendor and provider list for the center.

16. Performs other duties as required.

Minimum Education:

Bachelor’s degree in business administration, finance, statistics, information technology, or other health data information analysis related background required. Master’s degree preferred.

Current Cardio Pulmonary Resuscitation (CPR) certification required.

Minimum Requirements:

One to three years of experience in a healthcare analytics environment, preferably including financial tracking, operations, claims management, IT, and/or administration.

Knowledge of basic fiscal operations, accounting principles, and health plan administration.

Benefits:

• 403B/403B matching
• Employee assistance programs/discounts
• Dental/Vision insurance
• Health insurance after 30 days!
• Great team environment!
• Life insurance
• PTO/Sick days
• Referral programs/Tuition reimbursement

EOE/Disability/Vets

#CS-LP26