Healthcare Analyst - Fast Hire

We are looking for an energetic Healthcare Analyst to join our diverse team at TulaRay in Harrisburg, PA.
Growing your career as a Full Time Healthcare Analyst is an amazing opportunity to develop useful skills.
If you are strong in adaptability, creativity and have the right drive for the job, then apply for the position of Healthcare Analyst at TulaRay today!

Description of Work/Duties: Work full time hours of 37.5 per week At least 3 years of healthcare industry experience. A working knowledge of Medical Assistance is a plus, but not required. Also preferred is professional experience developing, implementing or evaluating human services, social services, health care services or health care insurance programs. Must have proficient computer skills to perform the responsibilities of this assignment. Experience with Microsoft Office programs such as Outlook, Excel, Word, Teams and using Outlook to managed work and schedule meetings is required. Demonstrated project management experience Analytical skills Strong written and verbal communication skills Ability to create executive level presentations Resolve cross-office issues as assigned Resolve complex consumer issues Function as part of a team who has the responsibility of monitoring the compliance of the HealthChoices Physical Health Managed Care Organizations (PH MCOs) with requirements related to serving members who have special health care needs and/or social determinants of health impacting their quality of life and health. The PH-MCOs are required to have Special Needs Units to address the needs of these individuals. The role of the BMCO Special Needs Unit is to ensure the PH-MCOs Special Needs Units are meeting their responsibility of assisting their members by coordinating members care, ensuring access to quality care, and connecting them with other care and services the individual and their family may need. This team plays a vital role in ensuring Physical Health HealthChoices members who are turning age 21 and aging out of Early Periodic Screen Diagnosis and Treatment (EPSDT) covered services, such as shift care, are able to transition to an appropriate waiver in order to ensure they can continue to live safely in their communities or other models of living. Monitor the PH-MCOs, the functions of their Special Needs Units and the work of their case managers. This will include ensuring the PH-MCO Case Managers compliance with the Standards of Practice for Case Management established by the Case Management Society of America (CMSA) and MCO compliance with the HealthChoices Agreement. Principal Duties and Responsibilities: Member of the Special Needs Resource Facilitation Team (RFT). This role is to ensure the transition of care for HealthChoices members who receive shift care under EPSDT to waiver at age 21 (Age Outs). Coordinates EPSDT Age Out transitions as assigned. Serves as back up for other staff for Resource Facilitation Team (RFT) and general age out issues as needed. Completes annual/quarterly SMART monitoring standards related to Special Needs Section of PH-HC Agreement. This includes onsite visits to the MCO's for monitoring. Works with the Monitoring and Compliance (M&C) staff in completing the Readiness Review process for areas related to Special Needs. Assists Special Need Unit Supervisor in completion and analyzing of various monthly/quarterly reports. Collaborates with clinical staff to coordinate discharge planning to an appropriate level of care. Responsible for planning, development, analysis, implementation, monitoring, evaluation and coordination in support of the responsibilities of the BMCO Special Needs Unit with a primary focus on HealthChoices contractors, Special Needs Units (SNUs,) EPSDT Age Out's and other special populations. Obtains and shares information on members being served by DHSs Adult Protective services, (APS) staff. Duties will include coordination with other DQSNC and PH-MCO staff to obtain information in support of APS staff in investigating and providing resolution to issues related to the needs of adults brought to the attention of APS. Responsibilities will include serving as the direct support to APS staff for APS serviced members who are covered under any PH-MCO within the Physical Health HealthChoices program. Participates and provides feedback at PH-MCO Contract Management Meetings, Quarterly Quality Review Meetings & others as assigned. Reviews PH-MCO initiatives that address the reduction/elimination of disparities. Interprets Medical Assistance policies, regulations, and procedures. Participates in Contract Management Team activities, onsite reviews and related activities as assigned. Reviews and analyzes Special Needs reports to identify trends and program needs. Works with supervisor to suggest, collect and analyze new data to assist with program decisions and MCO monitoring. Monitors and reports contractor compliance consistent with previously developed program or Request for Proposal (RFP)/contract requirements, monitoring plan standards or guidelines. Develops, provides, or participates in technical assistance training regarding Special Needs populations. Prepares reports, correspondence, file notes and other responses as approved by the Manager. Participates in assigned workgroups, committees, webinars and trainings and provides required follow up with supervisor, manager and/or director, including providing a file note. Performs other assigned duties and special projects as assigned by the Supervisor, Manager and /or Division Director. Coordinates efforts with the staff of BMCOs Division of Monitoring and Compliance (M&C) to address cases that require a review of the PH-MCOs case management of the member, difficult to staff shift care cases, and other cases identified as having multiple complexities. Coordinate and facilitate monthly and AdHoc calls with the PH-MCOs they are assigned to conduct case reviews/discussions for these complex cases. Staff will be responsible for documenting these calls. This documentation will be used to track and measure the efforts made to address the barriers as discussed on the calls. Provide summaries of these cases to supervisor, manager, director, and others as directed by supervisor and/or manager. Resolves problems and/or issues consistent with the PH-HC agreement, have knowledge of Department goals and work independently. Issues that have a major impact on other program offices or involve a major barrier to care for a member must be discussed with the Supervisor, Manager, and/or the Division Director. About Us: TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs. TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com

Benefits of working as a Healthcare Analyst in Harrisburg, PA:

● Company offers great benefits
● Opportunities to grow
● Attractive package