Operations Business Analysis Manager

Come Grow With Us
At Gold Coast Health Plan, we are driven to create the health plan of the future - today. We are disrupting the conventions of the health care industry by creating and applying leading-edge solutions to its many challenges.

Working at Gold Coast Health Plan means working alongside a team of committed individuals who are reshaping the organization and redefining how the needs of the whole person – health, health care, and social services and supports – are met. We are seeking collaborators, innovators, and those who are driven to be their very best.

If you are looking for a career of purpose and are passionate about having an impact on society’s health care challenges, then Gold Coast Health Plan is where you should be. Here, you will be challenged and rewarded in equal measure.

About this role:

Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

**This role is open to California residents only.**

ESSENTIAL FUNCTIONS
Job Function & Responsibilities

•    Provide direct supervision, coaching, performance management, and professional development for Ops Business Analyst staff.
•    Lead and manage the Ops Business Analyst function supporting operational domains 
•    Establish consistent standards and best practices for requirements gathering business requirements documentation, process mapping, testing, implementation support, and post-implementation validation.
•    Assign and prioritize Business Analyst resources based on organizational priorities, project complexity, operational risk, and available capacity.
•    Ensure Business Analysts develop expertise within assigned operational domains and serve as effective liaisons between Operations, Information Technology, vendors, and other stakeholders.
•    Provide oversight and quality review of business requirements, process documentation, workflows, test plans, and other analyst deliverables.
•    Partner with operational leaders to identify business needs, process gaps, risks, and opportunities for improvement.
•    Translate strategic and operational objectives into actionable initiatives and ensure requirements accurately represent business needs.
•    Facilitate cross-functional discussions to resolve complex business requirements, competing priorities, and implementation challenges.
•    Oversee analysis of current-state and future-state business processes and identify opportunities for automation, standardization, and operational efficiency.
•    Support project planning, prioritization, implementation, and post-implementation evaluation for operational initiatives.
•    Partner with Data Analysts and Operations Analytics leadership to identify analytical requirements, KPIs, and reporting needs associated with operational initiatives.
•    Collaborate with Information Technology to ensure business requirements are understood, appropriately prioritized, and translated into effective technical solutions.
•    Monitor project progress, dependencies, risks, and issues and escalate concerns when appropriate.
•    Ensure Business Analysts effectively support user acceptance testing, implementation readiness, and validation of delivered solutions.
•    Develop and maintain processes for tracking Business Analyst workload, project status, deliverables, and outcomes.
•    Promote collaboration, accountability, continuous improvement, and knowledge sharing across the Business Analyst team.
•    Develop team capabilities through mentoring, training, succession planning, and identification of professional development opportunities.
•    Prepare and present project updates, recommendations, risks, and findings to operational leadership and other stakeholders.
•    Perform other duties as assigned.

MINIMUM QUALIFICATIONS
Education & Experience:
•    Bachelor's Degree in Business Administration, Healthcare Administration, Information Systems, Business Analytics, or a related field.
•    Six plus (6+)  years of progressively responsible experience in business analysis, process improvement, healthcare operations, project management, or related work.
•    Minimum Two plus (2+) years of experience leading projects, teams, or employees preferred.
•    Demonstrated experience gathering and documenting complex business requirements and translating business needs into actionable solutions.
•    Experience partnering with technical and operational stakeholders on system implementations or process improvement initiatives.
Equivalent In lieu of degree: Will accept experience in any combination of academic education, professional training, or work experience, which demonstrates the ability to perform the duties of the position.
•    Ten (10) years of progressively responsible experience in business analysis, process improvement, healthcare operations, project management, or related work.

KNOWLEDGE, SKILLS & ABILITIES    
Preferred Qualifications:    
•    Managed care or healthcare operations experience.
•    Medi-Cal/Medicaid managed care experience.
•    Experience leading or supervising Business Analysts.
•    Experience supporting enterprise system implementations and operational transformation initiatives.
•    Knowledge of claims, membership and eligibility, appeals and grievances, contact center operations, configuration, correspondence, or other managed care operational functions.
•    Experience with Agile, Scrum, Waterfall, or hybrid project delivery methodologies.
•    Experience developing business requirements documents, process maps, workflows, user stories, and acceptance criteria.
•    Experience with operational process improvement and automation initiatives.
•    Six (6) years of experience leading projects, teams, or employees preferred.

    
Technology & Software Skills: 
•    Advanced Microsoft Office skills.
•    Microsoft Visio or equivalent process-mapping tools.
•    Jira, Azure DevOps, or equivalent work-management tools preferred.
•    Power BI or other data visualization tools preferred.
•    Working knowledge of SQL and relational data concepts preferred.
•    Experience with enterprise healthcare systems and business applications preferred.

Certifications & Licenses: 
Certified Business Analysis Professional (CBAP), PMI Professional in Business Analysis (PMI-PBA), Project Management Professional (PMP), Lean Six Sigma, or similar professional certification preferred.

Competency Statements:
•    Leadership – Ability to establish direction, develop employees, delegate effectively, and create accountability for results.
•    Business Acumen – Ability to understand operational objectives and translate them into actionable business solutions.
•    Strategic Planning – Ability to align team resources and initiatives with departmental and organizational priorities.
•    People Development – Ability to coach, mentor, provide feedback, and develop employees for increasing levels of responsibility.
•    Decision Making – Ability to evaluate information, competing priorities, and risks to make sound business decisions.
•    Analytical Skills – Ability to analyze complex business processes, identify root causes, and develop appropriate solutions.
•    Systems Analysis – Ability to understand how business processes, technology, data, and operational changes interact.
•    Process Improvement – Ability to identify opportunities to improve efficiency, quality, compliance, and operational performance.
•    Project Management – Ability to organize resources, priorities, dependencies, and deliverables to achieve defined outcomes.
•    Consensus Building – Ability to bring stakeholders together and facilitate agreement on complex or competing business needs.
•    Relationship Building – Ability to establish effective working relationships across departments and organizational levels.
•    Communication, Oral and Written – Ability to communicate complex information clearly and effectively to technical and non-technical audiences.
 

The estimated pay range for the position is:

$120,000.00 - $180,000.00

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

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