Business Systems Analyst Adv

Blue Cross Blue Shield of Michigan•Detroit, MI

About The Position

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures. Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology. Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget. Ensure all system development lifecycle processes and standards are followed. Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications. Provide analytical support related to business applications, infrastructure and technology related activities. May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries. Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems. Develop system solutions by preparing and evaluating alternative workflow solutions. Perform release management and end to end testing of system changes. Identify, investigate, resolve and escalate problems a needed. Gather data to support recommendations to address problems. Procure additional technical assistance to help in problem resolution. Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s). Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement. Develop process requirements and recommendations and communicate for the implementation of technical business solutions. Design and develop reports and data delivery to accommodate changing business requirements. Investigate, resolve and escalate problems. Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements. Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members.

Requirements

Bachelor’s degree in related field preferred.
Three (3) years of relevant technical or business work experience required.
Experience in managing cross functional teams or projects required.
Advanced knowledge preferred in system development life cycle, process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL, and computer programming languages.
Basic knowledge of business operations and systems requirement processes.
Strong technical, analytical, systems skills.
Display innovation in identifying, proposing, and overseeing the execution of business solutions.
Written and verbal communication skills; interpersonal skills.
Ability to provide technical or business guidance to clients, both internal and external.
Ability to work independently, or within a team environment.
Other related skills and/or abilities may be required to perform this job.

Nice To Haves

Expert knowledge of Payment Integrity is preferred.
Knowledge of SQL is preferred.
Knowledge and experience of conducting corporate and InterPlan audit reviews to ensure data and financial accuracy is preferred.
Knowledge of clinical editing systems and concepts is preferred.
Familiarity with claims processing and payment policy on NASCO and Facets is preferred.
Demonstrates extensive and broad base knowledge of NASCO claims end to end from a system and business perspective is preferred.
Expert knowledge of BlueCard policies, procedures and system design is preferred.
Experience with review and providing input to testing strategies, test scenarios, regression testing, execution, validation, and approval is preferred.
Experience with NCCI billing standards, and CMS mandates is preferred.

Responsibilities

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement.
Serve as a liaison between the business area and the IT organization when needed.
Identify, document and communicate system and process changes necessary to improve system and operational performance measures.
Contribute to the identification, analysis and recommendation of technical process improvement initiatives.
Design, create and implement technical solutions.
Support complex business processes.
Conduct data gathering and analysis to understand business strategy requirements.
Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction.
Evaluate ongoing department activity and propose new tools or technologies
Assist in the business process redesign and documentation as needed for new technology.
Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget.
Ensure all system development lifecycle processes and standards are followed.
Design, code, test, debug, document, implement and maintain complex business applications.
Provide ongoing maintenance of applications.
Provide analytical support related to business applications, infrastructure and technology related activities.
May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries.
Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems.
Develop system solutions by preparing and evaluating alternative workflow solutions.
Perform release management and end to end testing of system changes.
Identify, investigate, resolve and escalate problems a needed.
Gather data to support recommendations to address problems.
Procure additional technical assistance to help in problem resolution.
Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s).
Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement.
Develop process requirements and recommendations and communicate for the implementation of technical business solutions.
Design and develop reports and data delivery to accommodate changing business requirements.
Investigate, resolve and escalate problems.
Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements.
Train and educate users on new and existing tools.
Coach and transfer knowledge to less experienced team members.