Senior Analyst, CORE

Position Summary:

The Senior Analyst, CORE supports the day-to-day activities of the Committee on Operating Rules for Information Exchange (CORE), an initiative of CAQH. This position serves a critical role in supporting the healthcare industry with the development and implementation of operating rules that address critical topics including interoperability, prior authorization, value-based payment, etc. The Senior Analyst assists with the management of multi-stakeholder work groups composed of representatives from health plans, providers, vendors, clearinghouses, associations, and government entities. A key responsibility of this role is managing the identification and development of potential new operating rules to adapt to changing market needs and align with current and developing technologies. The position involves technical analysis of interoperability standards, workgroup management and planning, and implementation tool development. This is a full-time, exempt, remote position.

Specific Responsibilities:

• Researches, designs and drafts content for CAQH CORE Work Groups, which develop and maintain healthcare industry operating rules with a focus on technology.
  1. Develops technical analyses, research summaries, work group facilitation documents, and draft operating rule requirements, in collaboration with subject matter experts.
  2. Develops tools such as technical guides, implementation tools, FAQs, etc. to assist the industry with implementation and maintenance of the CAQH CORE Operating Rules.
• Provides daily management of CAQH CORE Work Groups.
  1. Creates and manages task lists to track the internal document development and review cycle for work group deliverables.
  2. Uses work plans to organize and track work group progress; updates work plans as needed and communicates any impacts of updates to schedule or scope.
  3. Provides scheduling, logistical oversight, and meeting organization for work groups and related meetings (e.g., Co-Chair Prep Calls, Work Group Calls, etc.).
  4. Serves as a primary contact for CAQH CORE Work Group members who have questions regarding timelines, documents, and meeting agenda items.
  5. Maintains accurate and up-to-date lists of Work Group organizations and individual contacts in customer relationship management tool; monitors engagement and support levels throughout the rule development process; proactively provides recommendations to Manager as needed.
• Supports communication with and outreach to external industry organizations (health plans, healthcare providers, vendors, government entities, etc.).
  1. Participates in industry workgroups focused on healthcare standards and interoperability; analyzes technical documentation and identifies areas of alignment and opportunity for operating rules.
  2. Drafts and provides timely responses to inquiries from industry organizations regarding operating rule requirements, implementation, and tools/resources. Escalates significant issues to appropriate staff and develops recommendations for organizational enhancements based on understanding of evolving CAQH CORE member needs.
  3. Creates presentations overviewing CAQH CORE projects and industry trends for external organizations (e.g., industry conferences, presentations to federal advisory committees, etc.).

Supervisory Responsibility:

None.

Skills:

• Desire and ability to learn new and challenging content areas.
• Strong writing skills with the ability to translate technical detail into business language as needed.
• Excellent qualitative and quantitative analytic capabilities to evaluate, distill and interpret technical concepts for broader audiences.
• Ability to simultaneously perform multiple assignments and follow extensive work plans.
• Ability to outline slide flow and content for formal presentations to convey information effectively for executive audiences.
• Strong experience in Microsoft Word, PowerPoint and Excel; experience with Salesforce or other customer relationship management database software desired.
• Experience with survey development and analysis software - preferably Qualtrics - desired.
• Excellent interpersonal communication skills.
• Is inspired by the work of CAQH CORE and motivated to have a positive impact on simplifying the business of healthcare. Maintains an intellectual curiosity about how to accomplish this goal through industry collaboration.

Experience:

• Four years of related work experience in the healthcare industry, preferably in healthcare consulting, implementation, or health IT. Exposure to emerging technologies and trends in the healthcare industry preferred such as APIs, telehealth, digital health, etc.
• Knowledge of HL7, X12, WEDI, and other health IT efforts that develop standards, facilitate their use, and advocate for adoption.
• Knowledge of the healthcare revenue cycle and the key parties involved is desirable.

Education:

• Bachelor's degree required; business and technology disciplines preferred.
• Master's level class work and/or degree in healthcare informatics, healthcare business, or a related field is desirable.

WHO WE ARE

Named one of the "Best Places to Work" by Modern Healthcare for five consecutive years, CAQH has helped nearly 1,000 health plans, 1.6 million providers, government entities and vendors connect, exchange information, and operate more efficiently. CAQH technology-enabled solutions and its Committee on Operating Rules for Information Exchange (CORE) bring the healthcare industry together to make sharing business information more automated, predictable, and consistent. CAQH Explorations research opportunities to reduce the burden of manual processes in healthcare administration.

WHAT YOU GET

CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals - and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. We offer full-time remote work to all staff from any location and maintain a physical office (with many amenities) in downtown Washington, DC.

CAQH is an equal opportunity employer. It is our policy to recruit, hire, train, and promote individuals, as well as administer any and all personnel actions, without regard to race, color, religion, sex, national origin or ancestry, age, marital status, disability, protected veteran status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, matriculation, political affiliation, genetic information, source of income, place of residence, or any other characteristic protected by law. CAQH will not tolerate any unlawful discrimination and any such conduct is strictly prohibited.

Applicants have rights under the Family Medical Leave Act (FMLA), Equal Employment Opportunity (EEO), and the Employee Polygraph Protection Act (EPPA). If you are interested in applying for employment with CAQH and need an accommodation to apply for a posted position, contact CAQH Human Resources at 202-517-0436.

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