Sr Government Operations Analyst

Job description

Position Description The Senior Operations Business Analyst provides advanced analytical, reporting, and problem‑resolution support across Claims, Customer Service, Enrollment & Billing, and Appeals & Grievances. The role requires deep expertise in Medicare Advantage appeals and grievances, claims processing workflows, data models, and regulatory reporting. This position partners with operational, technical, clinical, and compliance teams to analyze trends, validate data universes, optimize processes, and ensure operational and regulatory performance standards are met. The analyst leverages strong technical acumen, including FACETS, reporting tools, and data extraction techniques, to drive improvements, ensure compliance, and support business decisions. Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be mo...