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Business Process Analyst - Risk Adjustment
Business Process Analyst - Risk AdjustmentHighmark Health • WA, Working at Home, Washington
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Business Process Analyst - Risk Adjustment

Business Process Analyst - Risk Adjustment

Highmark Health • WA, Working at Home, Washington
30+ days ago
Job type
  • Full-time
Job description

Description

JOB SUMMARY

This job provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. May troubleshoot errors, conduct impact analyses, and / or solve data rejection. Performs business analyses in one or more operational areas. Identifies process gaps and recommends process improvements for efficiencies. May provide guidance to Associate level employees.

This role sits within our Risk Adjustment team - it is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.

ESSENTIAL RESPONSIBILITIES

  • Intake operational objectives and gather information. May perform routine research and evaluate basic output requirements and formats. Communicate business operational requirements to internal groups responsible for developing / testing business requirements in various applications.
  • Coordinate, monitor, and report on the progress of projects to ensure adherence to defined project schedule. Communicate effectively with customers and colleagues. Successfully articulate issues, problems, and solutions. Conduct pre-and post-implementation review. Assist in the planning / designing and facilitation of functional walk-throughs. May require additional support from more experienced team members.
  • Manage small to intermediate cross-functional projects and change initiatives involved in the design and delivery of business process solutions, implementation strategies, and control measures, including scoping, leading, and influencing organizational change related to business processes and models.
  • Facilitate process improvement meetings and / or discussions.
  • Analyze the functions and operations of a business area / function and identify problem areas. Create process mapping and document current and future state business processes.
  • Recommend process efficiencies, strategies for improvement, and / or solutions to align technology with business strategies.
  • Assist in development of desktop procedures and / or training material.
  • Other duties as assigned.

EDUCATION

Required

  • High School Diploma / GED
  • Substitutions

  • None
  • Preferred

  • Bachelor's Degree
  • EXPERIENCE

    Required

  • 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, customer service, etc.)
  • Preferred

  • 1 - 3 years in the Health Insurance Industry
  • LICENSES OR CERTIFICATIONS

    Required

  • None
  • Preferred

  • None
  • SKILLS

  • Analysis of business problems / needs
  • Written & Oral Presentation Skills
  • Business Analysis
  • Business Process Design
  • Business Process Improvement
  • Business Process Mapping
  • Business Requirements
  • Collaborative Problem Solving
  • Project Management
  • Languages (other than English)

    None

    Travel Required

    0% - 25%

    PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

    Position Type

    Office-Based

    Teaches / trains others regularly

    Occasionally

    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

    Constantly

    Lifting : 10 to 25 pounds

    Never

    Lifting : 25 to 50 pounds

    Never

    Pay Range Minimum : $50,200.00

    Pay Range Maximum : $91,200.00

    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

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    Analyst Risk Adjustment • WA, Working at Home, Washington

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