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"Must be in PHILADELPHIA Area" W-2 only"
Job Description:
"Must be in PHILADELPHIA Area" W-2 only"
Job Description:
- Claims Operations is hiring a Sr. Inter-Plan Business Systems Analyst to join our Shared Services BlueCard and Operations Support Team.
- This professional will be responsible for supporting the Inter-Plan BlueCard business for all Independence product lines across multiple processing platforms performing as subject matter expert.
- Work with business partners to identify business systems requirements and develop business solutions working closely with internal and/or external vendors.
- Perform as senior level business contact to define business system requirements for areas of expertise.
- Build strong, collaborative working relationships with internal customers, management, external partners including Inter-Plan partners, outsourced IT solution providers, and other teams.
- Assist in developing systems criteria and project scope.
- Identify potential problems/defects, perform business analysis, and assist in defining system enhancements, modifications/change requests, and upgrades to meet business process objectives as defined by BCBSA National Program releases, BCBSA mandated initiatives, and internal processing enhancements.
- Collaborate with internal IBC Test Team and associated vendor teams to assist in creating thorough Test Plans and identify appropriate Test Case Scenarios supporting defect fixes, enhancements, and projects as required. Provide business validation of testing results.
- Coordinate testing with Inter-Plan partners and execute required Inter-Plan Release Global Certification/Partner Plan testing, reporting milestone status to the assigned Project Manager and/or Blue Cross Blue Shield Association (BCBSA).
- Support production business checkout as required including identification of post-implementation defect tracking.
- Identify opportunities for business process improvement and efficiencies to re-evaluate processes and operational workflows.
- Attend BCBSA workgroups representing Independence Blue Cross Family of Companies as required.
- Perform any other duties as may be assigned.
- A working knowledge and experience with BCBSA BlueCard claims processing and Inter-Plan Program policies.
- An understanding of the business environment and associated system platforms.
- Demonstrated effective organizational, analytical, technical (with business perspective) and interpersonal skills with detail-oriented focus. Must be able to present findings to management.
- Proven communication and analytical skills required to address and present most complex ideas and concepts to users, business systems analysts, and management.
- Ability to work with multiple business system platforms and have an extensive understanding of business process and system design.
- Effective facilitation and presentation skills necessary to demonstrate and train in business systems solutions in a clear and concise manner.
- Clearly define desk level procedures as required.
- Coordinate with internal and external project management staff as required.
- Knowledge of health insurance/health care/managed care environment preferred.
- Knowledge of HealthRules Payor claims adjudication platform a plus.