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J190858

Internal Business Systems Analyst

United Concordia Dental

Company :

United Concordia Dental

Job Description : 

JOB SUMMARY

This job performs business analysis tasks for the Government Business Unit’s Dental Network Command Center (NCC) 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

  • Identify and support provider training via contractual analysis and thorough knowledge of provider needs; assist Marketing and Dental Network Solutions in development of training materials.
  • Support GBU Dental Director with provider audits to ensure contractual obligations, quality of care and safety are prioritized and appropriately acted upon.
  • Analyze GBU network providers via surveys or other tools to ensure compliance with access performance requirements; provide insight and thorough recommendations to meet Government expectations and contractual requirements.
  • Work with customers, Application Developers, and other team members to capture capability needs and drive quality business solutions. 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 participating on project teams based upon experience and need.
  • Support various aspects of requirements testing (e.g. testing plan, testing scenarios, testing scheduled, testing outcomes, user task analysis, documentation, defect management, results analysis) to ensure minimal production defects are realized
  • Ensure compliance for required standards (e.g. SOC 2) and obtainment of all necessary approvals throughout the project lifecycle.
  • Run system reports and/or create ad-hoc reports, pulling data from various sources. Analyze reports to ensure system performance and/or results.
  • Effectively communicate with team members, customers, partners, and management by reporting project status, enabling vendor solutions, and providing accurate and concise documentation.
  • Other duties as assigned.

EDUCATION

Required

  • High School Diploma/GED

Substitutions

  • None

Preferred

  • Bachelor's Degree in Information Systems or Business Administration/Management

EXPERIENCE

Required

  • 3 - 5 years in a relevant operational area (e.g. customer service, claims, enrollment and billing, etc.) to include 1 - 3 years of technical application experience

** Due to Department of Defense (DOD) contract requirements, the incumbent who fills this position must be a US citizen, and must also pass a background check **

Preferred

  • 1 - 3 years in the Health Insurance Industry
  • 1 - 3 years in the Healthcare Industry
  • 1 - 3 years in Lean/Six Sigma

LICENSES AND CERTIFICATIONS

Require

  • 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

Rarely

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

Rarely

Lifting: 10 to 25 pounds

Never

Lifting: 25 to 50 pounds

Never

Referral Level 2

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 job 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

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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