Value-Based Reimbursement Internal Business System Consultant

Job ID: J125891
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Nov 15, 2018

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Description

JOB SUMMARY

This job performs business analysis tasks by supporting stakeholders of a specific system application(s), handling user inquiries/issues, and enhancements to the system. Has a deep understanding of a specific application or set of applications he/she supports, how users use the application, and what other systems integrate with the application. The incumbent understands how work is being conducted, and through analysis, determines solutions to the issue(s).  Works with stakeholders to identify solutions that may include training, a process change, or modifications to business rules.  Traces business requirements through to test plans and cases, reducing time to fix issues and identify anomalies. The incumbent interfaces with positions that are directly involved in the hard-key programming of applications as roles involved in the analysis of the overall business process(es). Uses functional and organizational knowledge to mentor junior resources.  

ESSENTIAL RESPONSIBILITIES

  • Take a lead role with customers, Application Developers, and other team members to capture capability needs and drive quality business solutions on complex issues. Create and maintain deliverables such as business vision, requirements, personalization to different clients, and user interface design.
  • Lead full project life cycle by actively taking a lead role on project teams, based upon experience and need.
  • Provide required business and/or subject matter expertise for both project and production related activities on complex issues, including new strategic programs or initiatives impacting current and existing systems.
  • Ensure compliance for required standards (e.g. SOC 2) and all necessary approvals have been obtained throughout the project lifecycle.
  • Interface with the business areas, technical staff, and project teams to drive value, return on investments and innovative solutions. This includes providing alternative solutions with maximum benefits while reducing cost (e.g. cost benefit analysis, pros/cons of solutions).
  • Take lead role in supporting various aspects of requirements testing (e.g. testing plan, testing scenarios, testing schedule, testing outcomes, user task analysis, documentation, defect management, results analysis) to ensure minimal production defects are realized.
  • Create ad-hoc reports pulling data from various sources and/or run system reports. Conduct complex analysis on reports to ensure system performance and/or results.
  • Communicate in an exemplary manner with team members, partners and management, including reporting project status, enabling solutions, and providing accurate and concise documentation.
  • Provide thought leadership and strategic direction in Product and Technology Solutions.
  • Other duties as assigned.

QUALIFICATIONS

Minimum

  • High School Diploma/GED
  • 7 - 10 years in a relevant operational area (e.g. customer service, claims, enrollment and billing, etc.) to include 5 - 7 years of technical application experience

Preferred

  • Bachelor's Degree in Information Systems or Business Administration/Management
  • 5 - 7 years in the Health Insurance Industry
  • 5 - 7 years in the Healthcare Industry
  • 5 - 7 years in Lean Six/Sigma
  • (Lean) Six Sigma
  • Project Management Professional (PMP)

SKILLS

  • Leadership
  • Process Improvement
  • Analytical Skills
  • Problem-Solving
  • Communication Skills
  • Presentation Delivery
  • Customer Service
  • Strategic Thinking

Employee Referral Level - 1

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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