Job Title- Business Analyst

Location- Philadelphia, PA (Hybrid- 3 Days Onsite)

Duration- 6 Months

Key Point:

We need a health payer SME (Not a typical BA role). Someone who knows about shared services expert with Claim, provider, Medicaid, and Medicare. We need people who are more on the Commercial side, not the government side. Look for people who have worked with any Blues, Elevance, Anthem, Cigna, Humana, UnitedHealth Group, Aetna, CVS, or any other health-payor or health insurance companies.

Job Description:

Responsibilities

• 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, and 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 client National Program releases, client mandated initiatives, and internal processing enhancements.
• Collaborate with internal client 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 or client association.
• 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 client s workgroups representing client Family of Companies as required.
• Perform any other duties as may be assigned.

Qualifications

The ideal candidate will possess:

• A working knowledge and experience with client s BlueCard 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.

Education and Experience

• Bachelor s degree in business administration preferred.
• In addition to degree, minimum 8 years proven working experience in a business unit necessary or equivalent external work experience.
• Demonstrated effective project management skills necessary.
• Strong demonstrated experience using Microsoft office products (Word, PowerPoint, Excel and Visio).
• Knowledge of project management tools and business systems methodology has context menu