JOB SUMMARY
This job performs business analysis tasks by supporting stakeholders of a specific system application(s), handling user inquiries/issues, and enhancements to the system. The incumbent has a deep understanding of a specific application or set of applications he/she supports, how users use the application, and what other systems integrate with the application. Understands how work is being conducted, and through analysis, determines solutions to the issue(s). Works with stakeholders to identify solutions that may include training, a process change, or modifications to business rules. Traces business requirements through to test plans and cases, reducing time to fix issues and identify anomalies. The incumbent interfaces with positions that are directly involved in the hard-key programming of applications as roles involved in the analysis of the overall business process(es). Uses functional and organizational knowledge to mentor junior resources.
ESSENTIAL RESPONSIBILITIES
Take a lead role with customers, Application Developers, and other team members to capture capability needs and drive quality business solutions on complex issues. Create and maintain deliverables such as business vision, requirements, personalization to different clients, and user interface design.
Participate in the full project life cycle by actively taking a lead role on project teams, based upon experience and need.
Provide required business and/or subject matter expertise for both project and production related activities on complex issues, including new strategic programs or initiatives impacting current and existing systems.
Ensure compliance for required standards (e.g. SOC 2) and all necessary approvals have been obtained throughout the project lifecycle.
Interface with the business areas, technical staff, and project teams to drive value, return on investments and innovative solutions. This includes providing alternative solutions with maximum benefits while reducing cost (e.g. cost benefit analysis, pros/cons of solutions).
Take lead role in supporting various aspects of requirements testing (e.g. testing plan, testing scenarios, testing schedule, testing outcomes, user task analysis, documentation, defect management, results analysis) to ensure minimal production defects are realized.
Run system reports and/or create more complex ad-hoc reports, pulling data from various sources. Conduct more complex analysis of the reports to ensure system performance and/or results.
Communicate in an exemplary manner with team members, partners and management, including reporting project status, enabling solutions, and providing accurate and concise documentation.
Provide thought leadership and strategic direction in Product and Technology Solutions.
Other duties as assigned.
EDUCATION
Required
High school diploma/GED
Preferred
Bachelor’s degree in Information Systems or Business Administration/Management
EXPERIENCE
Required
5 - 7 years in a relevant operational area (e.g. customer service, claims, enrollment and billing, etc.) to include 3 - 5 years of technical application experience
Preferred
Proficiency or experience in IBM mainframe, python, or other command prompting tools
Proficiency or experience in data blending in SAS, Dataiku, Microsoft Power query, or other data science tools
Proficiency or experience in Medicare, Medicare carrier, or third-party data broker of large data and financing
3 - 5 years in the Health Insurance Industry
3 - 5 years the Healthcare Industry
LICENSES AND CERTIFICATIONS
Required
None
Language (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based - Hybrid
Teaches / trains others regularly
Frequently
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Rarely
Lifting: 10 to 25 pounds
Never
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice