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Senior Business Systems Analyst

Salary undisclosed

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Job Description

Job Description
Job Title: Senior Business Systems Analyst USC only
Location: 100% remote (must be able to work EST hours)
This position is responsible for system configuration implementation of the strategic business and functional infrastructure of the underlying systems that support the respective business platforms for the Medicaid Business Unit market. Performs configuration change management activities related to benefits, business rules, screen design and functionality, templates, workflows, provider contracts, user task analysis, personalization to different plans, and user interface design and design requirements for systems setup, configurations and onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into systems parameters to ensure accurate managed care operations (i.e. enrollment & billing, claims processing, etc.).
This job supports one or more analytical aspects of the application product life cycle, including capability enablement with cross-team dependencies within a product scope. Uses significant independent judgement and discretion to collaborate with customers on the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities), analyze data to determine business problems, trends, or opportunities for process improvements, create/execute test plans, provide root cause analysis and corrective action plan, verify delivery of customer needs, and ensure quality delivery. Identifies, documents, and resolves risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Uses functional and organizational knowledge to mentor Associate, Intermediate, and Senior Business Systems Analysts, as well as others outside of immediate team.
Leads project teams or actively participates as a SME on the most complex projects (cross functional, with potential regulatory risk exposure, customer service & financial impacts). Acts as face to the customer; primary customer contact; may negotiate project requirements versus resources with customer. Resolves the most complex issues (may involve multiple systems) and/or develops alternative solutions with understanding of potential regulatory risk exposure and customer service & financial impacts, ensuring that resolution addresses all potential impacts. Includes hands-on configuration in production and test environments, incident tracking and resolution, release management and project management.
Act as a SME on how the most complex new enhancement/applications are developed using an expert level of understanding of end-to-end processes and potential integration issues. Requires expert level of understanding the end systems impact of changes across enterprise-wide systems (including regulatory risk exposure, customer service & financial impacts). Develops policies & procedures in support of standardized and accurate configuration and maintenance. Remains informed of all health plan contracts and amendments as well as code sets, fee schedule and pricing changes made by health plans, CMS and/or the states Medicaid programs.
Responsibilities:
  • Participate in the full software development life cycle by actively leading or acting as lead in given area of expertise on agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need.
  • Provide required business and/or subject matter expertise on most complex issues for both project and production related activities, including new strategic programs or initiatives impacting current and existing systems.
  • Ensure compliance to required standards and all necessary approvals have been obtained throughout the project lifecycle.
  • Interface with the business areas, customers, partners, vendors, technical staff and project teams to drive value, return on investments and innovative solutions. This includes providing alternative solutions, including vendor solution acquisitions, with maximum benefits while reducing cost (e.g. cost benefit analysis, pros/cons of solutions).
  • Lead in supporting various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts.
  • Communicate in an exemplary manner with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
  • Provide thought leadership and strategic direction in Product & Technology Solutions.
  • Other duties as assigned.
Required Qualifications:
  • Bachelor's Degree in Business Management, Information Systems, or closely related discipline
  • 7 - 10 years in IS/IT
  • 3 - 5 years in Project Management
  • Experience with HealthEdge HRP
  • Hands on configuration experience
  • Knowledge of Medicare & Medicaid programs and their benefits
  • 3 - 5 years in the Health Insurance/Healthcare Industry
  • Analytical Skills
  • Problem-Solving
  • Communication Skills
  • Report Writing
  • SQL
  • Project Management
  • Customer Service
  • Leadership
  • Agile Methodology
  • Agile Project Management
Preferred Qualifications:
  • Master's Degree in Business Administration/Management or Information Systems
  • 5 - 7 years in Process Improvement
  • Experience working in a SaaS model
  • Health Source previously known as Burgess
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
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