Senior Business Analyst - Credentialing

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The Credentialing Senior Business Analyst will provide primary analytical, reporting, and quality assurance support for the Credentialing Department, with a focus on ensuring accurate, reliable, and compliant reporting across operational, departmental, regulatory, and accreditation requirements.

As a newly established role, the Credentialing Senior Business Analyst will focus primarily on Credentialing operations. As the function reaches steady state, the role will expand to include cross-training and support across other operational areas within the leader's scope.

Department-Specific Responsibilities:

• Serve as the Credentialing Department's primary business analyst and reporting liaison, partnering with the Analytics Center of Excellence (ACOE), Business Intelligence (BI), Epic teams, internal stakeholders, and external vendor partners to develop, implement, validate, maintain, and continuously improve required Credentialing reporting and analytics.
• Lead the development and ongoing enhancement of Credentialing reporting and dashboards, including regulatory, accreditation, operational, departmental, quality assurance, and performance reporting, ensuring outputs are accurate, actionable, and aligned with business and compliance requirements.
• Develop and maintain a comprehensive understanding of Credentialing workflows, business processes, systems, data sources, and vendor processes to translate operational and regulatory needs into clear reporting requirements, data specifications, business rules, metrics, calculation methodologies, and validation criteria.
• Maintain working knowledge of applicable CMS, NCQA, DHA, MDH and other and other regulatory or accreditation reporting and audit requirements, and support organizational readiness by ensuring required reports, data elements, metrics, supporting documentation, and audit details are accurate, reproducible, and readily available.
• Perform quality assurance and validation of newly developed and existing reports, dashboards, data extracts, and metrics to ensure accuracy, completeness, consistency, and alignment with defined business requirements; investigate and resolve data integrity issues and discrepancies as needed.
• Partner with internal and external stakeholders to identify, reconcile, and appropriately integrate data from multiple systems and vendor sources when required to produce complete Credentialing reporting.
• Establish and maintain clear definitions, business rules, data sources, calculation methodologies, and validation processes for key Credentialing metrics to promote consistency and a single source of truth.
• Analyze Credentialing data to identify trends, performance opportunities, data integrity concerns, process gaps, and emerging compliance risks, translating findings into actionable insights and recommendations for departmental leadership.
• Partner with Credentialing leadership and operational teams to continuously evaluate reporting needs and identify opportunities to automate reporting, improve data quality, reduce manual processes, and strengthen departmental oversight and decision-making.
• Maintain comprehensive reporting and analytics documentation, including requirements, metric definitions, data sources, business rules, validation results, and change history to support operational continuity, audit readiness, and knowledge management.
• Serve as a subject matter resource for Credentialing data and reporting, supporting leadership and…