DHS ForwardHealth Analyst

Network Health's success is rooted in its mission to build healthy and thriving Wisconsin communities. We are seeking a DHS ForwardHealth Analyst to join our team.

This role is responsible for ensuring that our systems and processes comply with all legal and regulatory requirements. The DHS ForwardHealth Analyst applies technical expertise to assess, implement, and maintain compliance while promoting efficient processing protocols.

Key Responsibilities:

• Monitor and research regulatory changes to ensure ongoing compliance.
• Collaborate with technical and business teams to design and implement compliant processes.
• Develop and enforce policies and procedures that support compliance and operational efficiency.
• Interpret data and identify trends to guide decision-making.
• Conduct audits and assessments to validate compliance and recommend improvements.

This position requires a strong understanding of departmental operations and the ability to build and maintain effective relationships across internal teams, the Department of Health Services (DHS), and external clients.

Location:
Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.

Hours:
1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2024 Annual Report video to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Demonstrate commitment to the philosophy, mission, values, and vision of Network Health.
• Monitor regulatory changes and emerging compliance trends, advising leadership on organizational implications.
• Serve as the primary point of contact for DHS technical updates, inquiries, and audits, ensuring timely and accurate responses and documentation.
• Use query tools (e.g., SAS, SQL, Tableau) to develop and distribute information from integrated databases (e.g., Data Warehouse, Excel, third-party data), validating reports for accuracy.
• Interpret data, identify trends, establish and apply benchmarks, and present findings in clear and actionable formats, including data visualizations.
• Document processes for transforming raw data into meaningful information, providing stakeholders with complete reports, analysis, and process details.
• Develop, implement, and maintain compliance policies and procedures to ensure adherence to applicable laws and regulations.
• Collaborate with cross-functional teams to integrate DHS compliance considerations into business strategies and operations.
• Conduct risk assessments and compliance audits, delivering actionable insights to mitigate risks and strengthen operational effectiveness.
• Lead training initiatives to increase organizational awareness and effective use of ForwardHealth technical tools.
• Support project management by tracking progress, maintaining timelines, and aligning deliverables with business objectives.
• Assist with regulatory and compliance reporting as required by DHS standards and governing bodies.
• Perform other duties as assigned.

Job Requirements:

• High school diploma or equivalent required; associate or bachelor's degree preferred.
• 3+ years of experience in a technical and/or compliance-related role involving data analysis for Medicaid.
• Strong analytical skills with the ability to assess complex information and make data-driven decisions.
• Proven problem-solving abilities with a proactive approach to identifying compliance risks and recommending solutions.
• Experience conducting policy analysis, including interpreting laws and policies, performing research, evaluating alternatives, and making recommendations.
• Knowledge of project and change management principles (e.g., planning, communication, stakeholder engagement, training, monitoring, and evaluation).
• Ability to analyze and design complex business/technical solutions and translate findings into actionable insights.
• Strong communication skills to effectively gather requirements, write specifications, and translate technical concepts for business users.
• Experience collaborating with cross-functional teams to document business needs, evaluate processes, and identify opportunities for efficiency improvements.
• Skilled in creating and supporting performance dashboards, KPIs, and other tools for data-driven decision-making.
• Familiarity with compliance management software and regulatory reporting tools.
• Ability to identify and resolve technical issues related to ForwardHealth programs.
• Strong understanding of DHS regulatory guidelines and their impact on business operations.
• Experience managing technical projects within the context of ForwardHealth initiatives.
• Familiarity with ForwardHealth programs and their technical requirements (preferred).
• Knowledge of insurance industry practices, including claims and policy administration (preferred).

Network Health is an Equal Opportunity Employer