Analista De Eficiencia Del Programa De Valor Al Afiliado
Regular
Non-Exempt
GENERAL DESCRIPTION:
The Beneficiary Value Program Efficiency Analyst is responsible for preserving the quality of the product by analyzing and developing operational data and report requests related to Te Paga. Provides administrative and analytical support in the implementation and monitoring of Te Paga-related initiatives, derived from regulatory requirements, new industry trends, and the company’s strategic plans. Supports the execution, validation, and continuous improvement of Te Paga operational processes and reports to the direct supervisor on the results of initiatives, implementations, and process performance.
ESSENTIAL FUNCTIONS:
- Analyzes and interprets data to provide recommendations for change based on judgment and experience, applies product policies and assesses risks to minimize exposure and mitigate risks.
- Processes and classifies data according to the established policies and documents any modifications in the internal records.
- Assists in the implementation of initiatives related to the unit, ensuring compliance with regulatory agencies, and facilitating the attainment of corporate and departmental goals and objectives.
- Follows a detailed work plan for each initiative, documenting the corresponding findings and results of each initiative or referral.
- Collaborates with Program’s team members to identify projects gaps, barriers and opportunities for improvements.
- Follows up on assigned items and promptly notifies the direct supervisor of any findings.
- Validates vendor’s error reports generated and process any applicable correction.
- Investigates and resolves discrepancies in transactions reported by internal or external teams.
- Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
- May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.
MINIMUM QUALIFICATIONS
Education and Experience: Bachelor’s degree preferably in Business Administration or related areas. At least one (1) year of experience in process analysis, audit or controls-related positions preferably within the health insurance industry and Medicare Advantage or in the banking industry managing debit cards.
OR
Education and Experience: At least sixty to sixty-four (60-64) approved university credits equivalent to two (2) years of studies or an Associate Degree in Business Administration or related areas. At least three (3) years of experience in process analysis, audit or controls-related positions preferably within the Health Insurance Industry and Medicare Advantage or in the banking industry managing debit cards.
“Proven experience may be replaced by previously established requirements.”
Certifications / Licenses: N/A Other: Availability to work on weekends, holidays, and extended hours as needed based on operational requirements.
Languages:
Spanish – Intermediate (comprehensive, writing and verbal)
English – Intermediate (comprehensive, writing and verbal)
“We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.”
