Company :Highmark Inc.
Job Description :
This job provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality for provider data. The incumbent reviews significant amounts of provider data information and analyzes processes to support business unit needs to maintain/cleanse existing system provider data and prepare it for transition to new system. May troubleshoot provider data and data process errors, conduct impact analyses, and/or solve data rejection problems. 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.
- 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.
- High School Diploma/GED
- Bachelor's Degree
- 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.)
- 1 - 3 years in the Health Insurance Industry
- Hands on experience with provider data configuration
- Government program or Medicaid Knowledge
LICENSES OR CERTIFICATIONS
- 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
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 position 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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
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