Company :HM Health Solutions
Job Description :
This job supports one or more analytical aspects of the application product life cycle, within a sub-product scope (one or more application components). Uses regular judgement and discretion to collaborate with customers in order to: Understand capability needs; Gather project specifications; Create business cases and cost sheet analysis; Translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities); Analyze data to determine business problems, trends, or opportunities for process improvements; Create/execute test cases; Provide root cause analysis and corrective action plans; Verify delivery of customer needs, and Ensure quality delivery. The incumbent identifies, documents, and resolves risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Builds organizational and platform knowledge in one or more disciplines to advance professional track career. Uses functional and organizational knowledge to mentor junior resources. Requires thorough understanding of end systems impact of changes across multiple systems.
- Work with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, requirements and personalization to different clients, and user interface design.
- Participate in the full software development life cycle by actively participating on Agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need.
- Support various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts.
- Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle.
- Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
- Other duties as assigned.
- Bachelor's Degree in Business Administration, Business Management, Information Systems, or related field
- 6 years of related experience
- 3 - 5 years in IS/IT
- Epic Professional Billing or other EHR billing experience
- Understanding of physician billing processes including: charging, claim submission, payment posting and/or insurance follow-up
- 1 - 3 years in Lean/Six Sigma experience
- 1 - 3 years in the Health Insurance Industry
- 1 - 3 years in the Healthcare industry
LICENSES OR CERTIFICATIONS
- Information Technology Infrastructure Library (ITIL)
- The Open Framework Group (TOGAF)
- Six Sigma
- Project Management Professional (PMP)
- Analytical Skills
- Communication Skills
- Report Writing
- Agile Methodology
- Agile 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.
Pay Range Minimum:$57,700.00
Pay Range Maximum:$106,700.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
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.
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