UCLA Health

Senior Business Systems Analyst, Medicare Advantage Plan

UCLA Health  •  $95k - $208k/yr  •  Remote  •  3 hours ago
Apply
AI can make mistakes so check important info. Chat history is never stored.

Job Description


General Information

Work Location: Los Angeles, CA, USA

Onsite or Remote

Flexible Hybrid

Work Schedule

Monday-Friday, 8:00am - 5:00pm PST

Posted Date

06/11/2026
Salary Range $95400 - 208300 Annually

Employment Type

2 - Staff: Career

Duration

Indefinite

Job #

31146


Primary Duties and Responsibilities

Reporting to the Associate Director of Delegated Oversight & Systems, the Senior Business Systems Analyst serves as technical authority responsible for delegated oversight reporting, business intelligence, data integration, and enterprise systems enablement. This role translates complex regulatory, operational, and business requirements into scalable data, reporting, workflow, and system solutions that support delegated oversight, audit readiness, performance accountability, and governance activities.

The role partners closely with Decision Support Services (DSS), OHIA, ISS, Compliance, Operations, Network Management, and Product teams to design, maintain, and optimize data marts, dashboards, reporting solutions, and business system workflows aligned with CMS, DMHC, NCQA, and organizational requirements. The incumbent must be independent judgment and advanced analytical expertise in managing complex reporting, data management, and system-related initiatives that support executive decision-making, operational performance monitoring, and enterprise scalability.

Key Responsibilities:

Regulatory Reporting & Oversight Analytics

• Translate regulatory and operational requirements into scalable reporting, analytics, and performance monitoring solutions. Support regulatory reporting (UHMAP) and delegated entity oversight

• Support CMS, DMHC, NCQA, and organizational reporting requirements through development and maintenance of regulatory and operational reports.

• Analyze delegated entity performance, compliance, operational, and risk metrics through trend analysis, root-cause analysis, and performance monitoring methodologies.

• Elicit, document, and translate business, regulatory, and operational requirements into functional specifications and technical requirements.

• Support Salesforce enhancements, workflow design, reporting capabilities, and system optimization efforts supporting delegated oversight operations.

• Develop process flows, use cases, data models, business rules, validation logic, and testing documentation.

• Support User Acceptance Testing (UAT), quality assurance activities, and production validation efforts.

Salary Range: $95,400 - $208,300/annually


Job Qualifications

We’re seeking a detail-oriented analyst with:

Required:
• A Bachelor’s degree in Information Systems, Health Sciences, Data Analytics, Statistics, or related field, and/or equivalent combination of education and experience
• 5 or more years of experience in business systems analysis, data analysis, or reporting experience supporting healthcare operations, health plans, or regulated environments
• 5 or more years of experience translating business and regulatory requirements into technical specifications, data definitions, and reporting solutions
• 5 or more years of experience working with healthcare data sources such as claims, encounters, membership, provider, utilization management or vendor data
• 2-4 years of experience developing regulatory, compliance, or performance reporting (e.g. CMS, NCQA, DMHC, audit support)
• SQL or Data Analytics certification at hire or within reasonable time
• Tableau, Power BI, or equivalent BI certification at hire or within reasonable time
• Advanced SQL development and data querying skills (MS SQL Server preferred)
• Strong knowledge of healthcare data structures (claims, encounters, membership, providers)
• Proficiency in BI and analytics tools (Tableau)
• Ability to translate business questions into technical solutions
• Strong analytical, problem-solving, and documentation skills
• Effective written and verbal communication across technical and non-technical audiences

Preferred:
• A Master’s Degree in Computer or Data Science
• 2-4 years of experience supporting data marts, data warehouses, or enterprise reporting environments in collaboration with analytics or IT teams
• 1-3 years of experience working in cross-functional environments involving Compliance, Operations, Product, Analytics, or IT stakeholders
• Healthcare or Regulatory Reporting Certification (e.g. NCQA, CMS-related training)
• Serve as technical mentor to experienced Business Systems Analysts and reporting professionals
• Knowledge of data warehouse concepts, dimensional modeling, and data governance
• Experience with CMS, NCQA, and regulatory healthcare measures

Note: Skills may be subject to test.



As a condition of employment
, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

Current/former UC employees are subject to a personnel file review.
UCLA Health

About UCLA Health

For more than half a century, UCLA Health has provided the best in healthcare and the latest in medical technology to the people of Los Angeles and throughout the world.

Comprised of Ronald Reagan UCLA Medical Center, UCLA Medical Center Santa Monica, Resnick Neuropsychiatric Hospital at UCLA, UCLA Mattel Children's Hospital, UCLA West Valley Medical Center and the UCLA Medical Group with its wide-reaching system of primary-care and specialty-care offices throughout the region, UCLA Health is among the most comprehensive and advanced healthcare systems in the world.

Our physicians are world leaders in the diagnosis and treatment of complex illnesses, and our hospitals are among the best in the country. Consistently ranked one of the top ten hospitals in the nation and the best medical center in the western United States by U.S. News & World Report, Ronald Reagan UCLA Medical Center is at the cutting edge of biomedical research, and our doctors and scientists are leaders in performing pioneering work across an astounding range of disciplines, from organ transplantation and cardiac surgery to neurosurgery and cancer treatment, and bringing the latest discoveries to virtually every field of medicine.

Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Los Angeles, CA
Year Founded
1955
Social Media