Business Analyst III

Horizon Blue Cross Blue Shield of New Jersey•Hopewell, NJ

About The Position

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is a senior level position working independently with guidance only in the most complex situations.

Requirements

High School Diploma/GED required.
Bachelor degree preferred or relevant experience in lieu of degree.
Minimum of seven (7) years' experience in an operational role, or analytical role.
Knowledge of Healthcare industry required.
Knowledge of Project Management methodologies.

Nice To Haves

May require knowledge of Horizon Blue Cross Blue Shields products and services.
May require working knowledge of division operating plan and Horizon operating model.

Responsibilities

Investigate service related issues to identify root cause of issues; identify and communicate business needs assessments as necessary.
Develop forecasting tools using current technology/systems (Access, Excel, Monarch, etc.)
Translate business requirements and assist IT with the development of technical specifications.
Develop solutions based on data analysis to increase business efficiency.
Lead or participate in internal and external project workgroup(s) and presentations.
Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc.
Prepare materials for internal and external audit activities; review audit findings/reports for accuracy and completeness. If appropriate, formulate rebuttal and/or corrective action steps.
May coach/mentor less experienced staff, assist in on-boarding of new staff and/or distribute and follow-up on work assignments.
Perform other relevant tasks as assigned by management.
Responsible for using multiple data sets to create reports, conduct analysis and research, identify trends and assist with the forecasting of products.
Create databases, interactive reports and queries from multiple sources to provide reporting for various teams and leadership.
Conducts root cause analysis and partner with IT to implement solutions and monitor results to completion.
Partner with external vendors to reduce errors from billing reports to create efficiencies, reduce cost, and improve quality.
Provide forecasting and analytics for enrollment vendors to ensure appropriate resource allocation.
Reconcile vendor transactions billed in comparison to source systems.
Ensure vendors are billed based on contractual obligations.
Identify areas of opportunity with vendor billing and transactions and make recommendations to leadership.
Provides first level support on ID Card related issues.
May create databases, monitor forecasting, summarize findings, and make recommendations for improvement.