Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. We are currently hiring for a future start date of 1/1/2025. This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
On behalf of internal and external customers, gather and document business requirements, provide research and analysis related to project deliverables or production (break/fix) issues, conduct all necessary testing prior to delivery, and act as a liaison between business customers, external customers, project teams and other Agile teams. REQUIRED QUALIFICATIONS Required Work Experience (All levels)
- 2 years of experience in healthcare or insurance field with an emphasis on business processes or system analytics.
- 2 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business
- Or, 1-year experience in end-to-end business processes with increased exposure to system configuration and integrations
Required Education
- High-School Diploma or GED in general field of study (All Levels)
Required Licenses
Required Certifications
PREFERRED QUALIFICATIONS Preferred Work Experience (All levels)
- 5 years of experience in healthcare or insurance field with an emphasis on business processes and system analytics including EDI and integrations.
- 5 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside the business
- 1 year of experience in project management
Preferred Education
- Bachelor's Degree in Computer Science, Information Systems, Business, or related field (All levels)
Preferred Licenses
Preferred Certifications
- Business Analyst Certification (All levels)
- Six Sigma Certification (All levels)
- Software Testing Certifications (All levels)
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
Level 1
- Write and review business requirements, flow specifications or change requests
- Write test scripts, perform testing and post-production validation
- Conduct research and analysis for issue resolution relating to electronic transactions, medical management or clinical management systems, customer service applications, claim adjudication systems including reporting, process efficiencies. Track all items through to resolution.
- Provide first or second level support for internal/external customers
- Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
- Act as a liaison between external, all segment customers and all IT; communicate system and process changes to business areas
Level 2
- Develop moderate complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with limited management direction.
- Provide subject matter expert (SME) advice related to electronic transactions and other corporate systems in the prioritization of workload or issue research.
- Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities.
- Lead small to medium size projects.
- Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency, and completeness
- Resolve differences between customers and other team members to achieve organizational and project goals
- Utilize existing reporting tools to develop and execute data queries for ad hoc requests; understand data source structures
- Understand EDI formats/syntax and file transfer protocols
- Support multiple segments of business
- Mentors Level 1 Analysts
Level 3
- Develop complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with little to no management direction.
- Decompose high-level project information and evaluate project components to forecast work effort required
- Act as lead analyst for large or complex projects
- Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business.
- Fully support all business segments
- Mentors Level 1 and 2 Analysts
Level 4
- Ensures Service Level Agreements between department and operational or technical areas are met
- Act as lead analyst for large or complex projects with minimal guidance from lead or manager
- Mentors all level of analysts
- Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals
LEAD
- Serves as the primary operational contact for internal and external customers when needed or in the absence of the Manager
- Participates in evaluation and writing of performance reviews for level 1 and possibly level 2 analysts
- Develop and mentors' staff by providing opportunities for growth through delegation, training, and assignment to various project teams
- Informs the manager of any issues impacting the efficient and effective performance of the department including system, resource and informational barriers.
- Assist the manager in the day-to-day operations of the department
ALL LEVELS
- Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Participate in on-call rotation
- Perform all other duties as assigned
REQUIRED COMPETENCIES Required Job Skills (Applies to All Levels)
- Strong analytical skills to support independent and effective decisions based on customer input and research
- Strong problem-solving skills
- Strong time management skills
- Basic skills with core MS products: Word, Excel, Edge, Outlook, Visio, PowerPoint, Teams
- Basic skills with query tools
- Strong understanding of file handling and data translation
- Excellent verbal and written communication skills and the ability to interact professionally and maintain positive working relationships with a diverse group
Required Professional Competencies (Applies to All Levels)
- Prioritize tasks and work multiple priorities, sometimes under strict time constraints
- Ability to build synergy with a diverse team in an ever-changing environment
- Ability to exercise independent judgment and demonstrate creative problem-solving techniques
- Anticipates downstream impacts and factors in those considerations appropriately
- Perseverance in the face of resistance or setbacks
Required Leadership Experience and Competencies
- Support priorities and direction of corporate leadership
- Ability to apply sound management decision making skills to perform effectively in the absence of management
- Effectively deal with conflict
- Ability to present concepts effectively to varying levels of staff (Applies to Levels 2 - 4)
PREFERRED COMPETENCIES Preferred Job Skills (Applies to All Levels)
- Demonstrates an advanced knowledge of and experience with the development of business requirements, user stories, user acceptance testing and their supporting toolsets.
- Familiar with HIPAA compliance validation tools such as EDISM, Specbuilder or ClarEDI.
- Familiar with claims and customer service processes
- Experience with web portal business user support and change management activities
- Formal business analyst training
Preferred Professional Competencies (Applies to All Levels)
- Driven to identify solutions to meet customer needs.
- Ability to work with ambiguous and conflicting information while keeping focused on the end goal.
- Performs public speaking presentations within the industry
Preferred Leadership Experience and Competencies
Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group. Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
|