Senior Internal Business Systems Analyst

Description

JOB SUMMARY

• MUST BE A US CITIZEN

This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT,Legal and other departments, proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement effective controls and procedures to maintain compliance. 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

Monitor state, federal, and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate with their leadership to develop and implement policies, procedures, and training programs that ensure compliance with applicable regulations. Assist in the investigation and resolution of compliance-related incidents or complaints.

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

Excellent analytical, problem-solving, and critical-thinking skills

Strong communication, interpersonal, and presentation skills

Ability to work independently and as part of a team

3 - 5 years in the Health Insurance Industry

3 - 5 years the Healthcare Industry

3 - 5 years in Lean / Six Sigma

LICENSES AND CERTIFICATIONS

Required

None

Preferred

Lean) Six Sigma

Project Management Professional (PMP)

SKILLS

Leadership

Process Improvement

Analytical Skills

Problem-Solving

Communication Skills

Presentation Delivery

Customer Service

Strategic Thinking

Language (Other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

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

Lifting : up to 10 pounds

Rarely

Lifting : 10 to 25 pounds

Never

Lifting : 25 to 50 pounds

Never

Pay Range Minimum : 57,700.00

Pay Range Maximum : 107,800.00

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