Business Analyst III - Appeals & Grievances ( 10191) - Scout

Job description

Job Summary

The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review and documentation of functional business specifications. This position manages the requirements development process through the elicitation, analysis, specification and verification of multiple levels of requirements from an end-to-end perspective and supports the ongoing management of the requirements. This position will develop report and analysis for the department. It is responsible in communicating  and coordinating with IT on a day-to-day department related efforts. The Business Analyst III will manage and coordinate the implementation and/or integration of products or new features for clients including client training and provides subject matter expertise (SME) and support of the department's inbound and outbound functions. This position will act as mentor to Business Analysts I/ II.

Duties

Develop functional and user acceptance test plans and scenarios. Coordinate functional and user acceptance testing by executing the testing strategy, scheduling resources and tracking test performance. Perform data analysis to support evaluation of system defects or to develop requirements for new functionality; assist in various system trouble shooting and balancing and correction efforts including analysis, verification and validation of issues and fixes. Coordinate activities including on-time delivery, testing and production moves.

Collaborate with I.T. on all department  related efforts, including submission of Service Requests and writing BRD's. Coordinate related data requests from internal departments, and/or assist I.T. with definition of criteria. Delegate data and reporting requests to business analysts. Facilitate collaborative system and data design sessions with the user community, technical architecture resources and development resources. Preparation of status updates to enterprise for distribution and communication.

Work as a technical support and liaison to designated I.T. personnel to provide testing, support and feedback on enhancement requests and regular updates/releases; adhere to release schedules. Provide analytical support for critical corporate initiatives including business function support for system migrations and consolidations, significant business area process improvement projects and complex product installations.

Demonstrate a high level of subject matter expertise in functional area to bridge business requirements and I.T. solutions; provide technical direction and ensure compliance with best practice solutions. Practice knowledge transfer and foster change management as the organization changes and new skills are required, focusing on team/individual development to be a valued contributor.

Participate and contribute on the development/ creation of data models and interface design specifications. Support internal/ external stakeholder's roadmap and audits as needed.

Oversee the business process support across multiple client engagements. Communication with internal/ external stakeholders for department's submission requirements. Review submission of data against established benchmarks and coordinate correction and improvement efforts. Monitor timely and accurate outbound data submission to state and federal recipients.

Perform other duties as assigned.

Duties Continued

Education Required

Bachelor's Degree

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Experience

Required:
Proven analytical/technical aptitude evidenced by at least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, encounter processing. 

Skills

Required:
Competent to work at the highest technical level of most phases of systems analysis.

Excellent verbal and written communication skills.

Coaching, Mentoring and Teaching skills.

Teamwork-focused/collaborative work style.

Demonstrated ability to work successfully on large projects.

Problem solving skills evidenced by demonstrated results in past positions.

Ability to work under tight deadlines and handle multiple/detail-oriented tasks.

Ability to influence at all levels of the organization.

Proficient in Microsoft Office and Vizio.

What are the 3-4 non-negotiable requirements of this position?

Must have 5 years BA, Data Analysis, Claims processing experience QNXT Experience Healthcare industry

What are the nice-to-have skills?

Managed Care experience

Preferred:
Ability to work on other programs such as SharePoint and/ or OneNote

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information