Enterprise Business Analyst - State Based Exchange
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- Insurance and Safety Fire Commissioner, Office of - OCI
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- Dec 06, 2024 Post Date
Under general supervision, the Partner Integration Analyst analyzes enterprise-wide customer business needs and participates in the planning, design and implementation of new or enhanced systems that may serve multiple entities.
Supports partner-related coordination and activities, including the annual partner Operational Readiness Reviews (ORRs), change management, system testing, insurance carrier backend processes, and partner compliance reviews.
Provides partner oversight, including quarterly audits and annual reviews (third-party privacy and security audits, document review, etc.) for compliance.
Updates and maintains partner materials (e.g., application and user interface guide); provide to the partners upon review by management.
Develops materials and meet regularly with the partners to communicate program updates, technical progress, challenges, and mitigation strategies as needed.
In conjunction with vendors and partners, designs and operates reconciliation processes to ensure correct adequate alignment and exchanges of information across a complex value chain.
Provides support with implementing changes made by Centers for Medicare and Medicaid Services (CMS) to the Enhanced Direct Enrollment (EDE) program.
Coordinates and updates policies and business requirements to partners in conjunction with departmental staff.
Resolves escalated issues on the post-enrollment technical insurance carrier processes (e.g., 834 files, termination issues, payment issues, and reconciliation).
Performs other duties as assigned.