Business Analyst- Utilization Management

Quartz Health Solutions

Wisconsin, United StatesRemote OKFull time
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Pay
$78K to $98.5K
a year
Location
Wisconsin, United States
Work style
Remote OK
Job type
Full time
Posted
Oct 29
1 day ago
Career path

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About the company

Quartz Health Solutions

Hospital & health care · 501 to 1,000 employees

Quartz Health Solutions on LinkedIn

What you'll do

  • Analyze, design, configure, test, implement, and support UM and referral-related system solutions
  • Partner with stakeholders, IT teams, and vendors to define requirements and implement enhancements
  • Serve as a subject matter expert for UM configuration, workflows, and system functionality
  • Maintain ownership of UM systems, referral correspondence, work queues, reporting, and production support
  • Develop and maintain requirements, process documentation, policies, procedures, and test artifacts
  • Perform validation and quality assurance testing of system configurations and changes
  • Analyze data discrepancies, identify root causes, and recommend improvements
  • Provide guidance, training, and mentorship to team members

What you need

  • Knowledge of health insurance plans and application / utilization management
  • Experience working in an Epic – Tapestry strongly preferred
  • 2+ years of experience in Business Analyst role or equivalent experience
  • 2+ years of experience in prior support of systems including health insurance claims adjudication, eligibility, provider contracts, provider enrollment, EDI, or benefit plans.
  • Bachelor’s or Associate’s degree or related experience.
  • Advanced MS Office skills
  • Developing fluency with tools such as BusinessObjects, Chronicles, Visio
  • Strong verbal and written communication skills – able to effectively description ideas or difficult/ sensitive situations
  • Ability to interact across team/departments to achieve project and department goals
  • Ability to understand and discuss technical software issues with others
  • Ability to adapt to changing circumstances, accepting uncertainty and/or unpredictability
  • Education: a bachelor's degree or an associate degree

Key skills

health insurance plansutilization managementEpic – TapestryAdvanced MS Office skillsBusinessObjectsChroniclesVisio

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Perks

  • robust total rewards package
  • opportunity for career advancement

See full description on company page, apply now

Read the full posting here
Business Analyst- Utilization Management Job Locations US-WI ID 2026-2438 Category Business Analysis Type Regular Full-Time Overview Are you curious, detail-driven, and energized by solving puzzles that make a real impact? Quartz is looking for a collaborative and analytical Business Analyst to join our benefits configurations team. This role is perfect for someone who enjoys digging into data, connecting dots between business needs and system solutions, and building workflows that directly support our members, providers, and organizational goals. As a Business Analyst – Utilization Management, this position will be responsible for utilizing instructions, commonly used concepts, practices and procedures and appropriate system tools and resources to perform their job. This position will also develop various test plans that ensure that business requirements have been met while understanding business unit activities, goals and critical success factors that influence systems applications. Benefits: Fun, friendly, & experience team environment Ability to participate in projects that have real impacts on corporate goals In person, hybrid, or telecommute work options available Starting salary based upon skills and experience: $78,000 - $98,500 annually plus robust total rewards package Responsibilities Analyze, design, configure, test, implement, and support Utilization Management (UM) and referral-related system solutions. Partner with business stakeholders, IT teams, and vendors to define requirements, resolve issues, and implement system enhancements. Serve as a subject matter expert for UM configuration, workflows, business processes, and related system functionality. Maintain ownership of Prior Authorization, Referral, Criteria Review Software, referral correspondence, work queue configuration, reporting, and production support. Develop and maintain business requirements, process documentation, policies, procedures, and test artifacts. Perform validation and quality assurance testing of system configurations and changes to ensure accuracy and compliance with business requirements. Analyze data discrepancies, identify root causes, and recommend process or system improvements. Provide guidance, training, and mentorship to team members and support cross-functional project initiatives. Participate in change management, implementation, and continuous improvement efforts to enhance operational efficiency and member/provider experience. Qualifications Knowledge of health insurance plans and application / utilization management Experience working in an Epic – Tapestry strongly preferred 2+ years of experience in Business Analyst role or equivalent experience 2+ years of experience in prior support of systems including health insurance claims adjudication, eligibility, provider contracts, provider enrollment, EDI, or benefit plans. Bachelor’s or Associate’s degree or related experience. Advanced MS Office skills Developing fluency with tools such as BusinessObjects, Chronicles, Visio Strong verbal and written communication skills – able to effectively description ideas or difficult/ sensitive situations Ability to interact across team/departments to achieve project and department goals Ability to understand and discuss technical software issues with others Ability to adapt to changing circumstances, accepting uncertainty and/or unpredictability We offer an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check. Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified person with disability. #LI-DNI Options Apply for this job online Apply Share Email this job to a friend Refer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Need help finding the right job? We can recommend jobs specifically for you! Click here to get started. Application FAQs Software Powered by ICIMS www.icims.com

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