Resp & Qualifications

PURPOSE: 
We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.

This role will support the Health Services division in the optimization of our clinical and provider activities to help improve compliance, administrative efficiencies and cost of care reduction. This Senior Business Process Analyst will be able to: 1) Support the analysis and evaluation of business problems and the development of solutions to address identified problems. 2: Provide a single point of contact for those projects. 3) Take projects from original concept through final implementation. 4) Complete assignments such as problem definition, evaluation of requirements, and facilitation of the implementation of systems and/or process to meet business and user requirements. 5) Interface with all areas affected by the project including customer, IT, and other internal or external clients.
ESSENTIAL FUNCTIONS:

• Reviews complex business processes, systems, reports, and/or workflows to identify, document, and elevate the presence of risk and trends within, that may be opportunities for process improvement. Analyzes business processes and coordinates with impacted teams to analyze processes and resolve problems. This includes coordination and input to formulate and develop new and modified business information processing systems.
• Facilitate and interface with all areas affected by the project including customer, computer services, and client services.
• Lead the business unit to define requirements and business cases in the development of solutions.
• Identify current processes and potential changes to ensure increased operational efficiencies and productivity improvements.
• Conduct process analysis activities to include interviewing, observing, and timing of operational tasks for current state and future state. Map individual task workflow; create and maintain workflow charts for all major tasks; update and validate models, service agreements and cost benefit documentation.

SUPERVISORY RESPONSIBILITY:
Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.
QUALIFICATIONS:
Education Level: Bachelor's Degree in Business Administration, Business Management or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Licenses/Certifications Upon Hire:
Certified in Business Analysis -PMI
Experience: 5 years operational analysis experience or 2 years as a Business Process Analyst.
Preferred Qualifications:
Extensive knowledge of utilization management, care management, appeals & grievances, risk adjustment, provider processes and quality. 
Knowledge, Skills and Abilities (KSAs)

• Skill in analyzing and organizing technical data.
• Proficient in Microsoft Office programs.
• Excellent communication skills both written and verbal.
• Self-starter and ability to collaborate with associates of various levels.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $62,856 - $124,839

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Health Service Operations

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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