Business Operations Analyst IV - Member Enrollment Billing

Job Requirements

POSITION SUMMARY

The Business Operations Analyst IV leads highly complex, cross-functional business operations initiatives to improve performance, compliance, and customer outcomes, partnering with leadership , and business process owners to define the problem, establish success measures, and translate strategy into actionable insights and recommendations. The Business Operations Analyst IV builds reporting, controls, and monitors approaches that drive decision-making and accountability. The Business Operations Analyst IV spearheads projects, documents business requirements definition, and development of test and control plans.

The Business Operations Analyst IV mentors junior team members, and provides consultation on operations, data integrity, and operational risk.

PRIMARY

ACCOUNTABILITIES

* Leads discovery with business and operational stakeholders to clarify objectives, constraints, and success measures; frames ambiguous problems into structured analyses and decision-ready options.

* Defines data requirements and enables reliable access to data across sources; leads data validation, reconciliation, and documentation to ensure integrity, auditability, and consistent use of metrics.

* Establishes key performance indicator (KPI) frameworks and delivers executive-ready scorecards, dashboards, and performance narratives that support compliance and executive decision-making; drives alignment on definitions and ensures insights lead to action.

* Performs root cause analysis to identify drivers of performance, quantify impact, and recommend solutions; advises leaders on tradeoffs, risks, and controls to support sound decisions.

* Designs reporting for end-user tools that reduce manual effort and improve timeliness and accuracy; identifies system/process enhancement opportunities and partners with technology teams to deliver improvements.

* Takes ownership for the development of complex business solutions that improve administrative efficiency, compliance readiness, and customer satisfaction; defines measures, monitors results, and adjusts approach to achieve sustained impact.

* Spearheads process improvement initiatives using structured methods (e.g., Lean) and change management; establishes governance, documents standard work, and drives measurable improvements in cycle time, quality, cost, and service.

* Prepares and maintains compliance and regulatory reporting by interpreting technical specifications, extracting and validating data, and producing accurate, timely deliverables with appropriate controls.

* Administers the analysis and resolution of data, system, and application issues impacting reporting or operations; partners with technology teams and stakeholders to identify root cause, implement fixes, and prevent recurrence.

* Oversees end-to-end delivery for operational initiatives, including projects and process improvements, business requirements definition, process mapping, test planning/UAT support, and control plan development to ensure sustainable implementation.

Work Experience

MINIMUM QUALIFICATIONS

* Education:

Bachelor's degree in Business or Healthcare Administration, Information Technology, Computer Science, Math, Statistics, or a relevant field.

* Work Experience:

Five (5) years' experience in a business operations role, leading complex cross-functional initiatives and presenting insights and recommendations to senior leaders.

* Licensure:
None

* Certification:
Related professional certification (e.g., LEAN Six Sigma, Business Analysis, Change Management) within six (6) months of start date and maintained.

* Work Experience In Lieu of

Education:

Associate's degree and an additional two (2) years' experience a business operations role, leading complex cross-functional initiatives and presenting insights and recommendations to senior leaders.

* Skills/Knowledge/Abilities:

* Expert-level knowledge of data handling techniques, including data quality validation, controls, and documentation; ability to translate business questions into data requirements.

* Knowledge of Microsoft Office applications, especially Excel and PowerPoint, with the ability to create executive-ready materials…