Jobs Opening
Position ID :Q-IN-2017-PS042
Date Posted : 03-16-2017 (mm-dd-yyyy)
Jobs Title : Managed Care Business Analyst - Intern
No of Openings : 4

Job Classification: Internship

Qtech Solutions Inc.
3 Executive Drive, Suite 320
Somerset, New Jersey USA 08873.
Director Operations
NJ Phone : 732-770-4100 Fax: 888-532-0210
Email      :

Job Duties

This Training as Internship is conducted for 12 Weeks to Fresh and Alumni Students. Selection for Internship is based on GPA and Interview performance. Our Placement division supports various pharmaceutical, healthcare and financial firms, by providing staffing resources meeting cost efficiency, time saved and commitment to their hiring needs. Successful Intern, will be provided an opportunity to work at our client sites on contract as full-time employee of Qtech with benefits.

  • Leads a team of business analysts that support the organization in proactive and retrospective analysis, tracking, research, and problem resolution related to authorizations, utilization management and Clinical Operations.
  • Manages the overall program of tools and reports for the Clinical Operations team to assess and track authorization status, workload, turnaround time, pended claims, and other performance metrics.
  • Continually assesses and makes recommendations for ways to optimize the service coordination workflows for end to end efficiency and effectiveness.
  • Support short and long term operational / strategic business activities by assisting in the development, execution, management and maintenance M&R, CMS Star ratings and coding accuracy improvement strategy and performance.
  • Provide analytical support for CMS Star Ratings, HEDIS Measures, and EMR both in an outpatient and inpatient setting.
  • Conduct complex analyses (e.g., researches & analyzes policy, techniques & procedures for reconciliation & reimbursement strategies for Medicaid-contracting managed care plans [MCPs] & eligible consumers).
  • Monitors & evaluates program policies & procedures to assure compliance with federal & state regulations.
  • Provides consultative expertise & training & acts as liaison to both intra-agency & inter-agency providers (e.g., MCPs, enrollment, eligibility or encounter processing vendors).
  • Determines & implements necessary state Benefits eligibility system, Medicaid Information Technology System (MITS) & other programmatic changes & discrepancies.
  • Use case development, design, and testing; verifies reimbursements request & claims adjustments resulting from eligibility actions.
  • Responsible to investigate, document, and analyze client requirements in project areas such as: new/existing business operating models with innovative approaches to applicable department solutions support, market research of emerging or available product functionality and operational readiness assessment.
Education : Bachelors Degree in:
Healthcare Management, Business Administration, Information Technology, Computer Science, and Engineering (IT).
Experience : 0-2 years
Application End Date: 06-16-2017 (mm-dd-yy)

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