Job Description

Your career starts now. We're looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

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Role Overview: The Exchange Business Operations Analyst reports to the Exchange Business Implementation Manager and operationalizes the data analytics reporting of enrollment, billing, and reconciliation (EB&R) data across all Exchange markets. The ideal candidate will have a strong understanding of enrollment, membership operations, as well as the reconciliation processes, including familiarity with Centers for Medicare & Medicaid Services (CMS) file types such as 834, 820, RCNO, RCNI, EAPS, HICS, and others.

Work Arrangement:

• Remote - Associate can work remotely anywhere in the United States.

Responsibilities:

• Assist in analyzing the Affordable Care Act (ACA) Enrollment Reconciliation processes to identify areas for improvement.

• Develop data-driven reporting and identify opportunities for operational efficiencies related to Enrollment Alignment Performance Summary (EAPS) Reports.

• Ensure accuracy in data analysis and recognize anomalies or errors in data

• Collaborate with internal stakeholders and external vendors on analytic research and root cause analysis

• Presents analysis, ideas, and positions in writing in a clear and concise manner

• Manage the departmental SharePoint site

• Other duties and responsibilities as assigned.

Education & Experience:

• High School diploma/GED required.;

• An associate's degree or equivalent work experience.

• 3 to 5 years of experience in ACA business analysis or a similar regulatory environment.

• Advanced knowledge of Microsoft Office Suite and Facets.

Skills & Abilities:

• Possess a strong analytical and critical thinking aptitude, with the ability to translate thinking into action.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

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