Sr. Business Analyst, Commercial (Remote/Hybrid) - Blue Cross Blue Shield of Arizona

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

This position is remote/hybrid within the state of AZ only

PURPOSE OF THE JOB

The Sr. Business Analyst, Commercial supports any BCBSAZ Commercial Segment project as a single resource representing corporate wide knowledge of business and functional processes. This combines the skillsets of a Project Manager, Business Analyst, Data/Reporting Analyst, Process Improvement Analyst, External Vendor Management Liaison, and Consultant.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

1. Required Work Experience

· 7 years of demonstrated experience in healthcare or insurance field in at least four of the following areas:

· Project Management, including scope/schedule/cost documentation, analysis, and reporting

· Program Management, including operational oversight and goal setting and measurement.

· Business Analysis, including Business Requirements Documents and User Stories, Test Strategies, Test Criteria, Defects, etc.

· Healthcare Quality Management

· Data/Reporting Analysis using Excel, Access, Tableau, SQL, or SAS

· Process Improvement, including Business Process Engineering (Current State vs. Future State Analysis, Gap Analysis, and Workflow Diagrams)

· External Vendor Management, including working with and/or managing External Vendor relationships

· Consulting, including Sponsor/Business Lead management and the ability to identify and resolve business or technical problems in a variety of team and organizational environments

· 3 year of experience implementing systems and business processes

2. Required Education

· High School Diploma

3. Required Licenses

· N/A

4. Required Certifications

· N/A

PREFERRED QUALIFICATIONS

1. Preferred Work Experience (All levels)

· 10 years of demonstrated experience in healthcare or insurance field in four or more of the following areas:

· Project Management, including scope/schedule/cost documentation, analysis, and reporting

· Program Management including operational oversight and goal setting and measurement.

· Business Analysis, including Business Requirements Documents and User Stories, Test Strategies, Test Criteria, Defects, etc.

· Healthcare Quality Management

· Data/Reporting Analysis using Excel, Tableau, Access, SQL, or SAS

· Process Improvement, including Business Process Engineering (Current State vs. Future State Analysis, Gap Analysis, and Workflow Diagrams)

· External Vendor Management, including working with and/or managing External Vendor relationships

· Consulting, including Sponsor/Business Lead management and the ability to identify and resolve business or technical problems in a variety of team and organizational environments

· 5 years of experience as a subject matter expert in at least two of the above areas.

2. Preferred Education

· Bachelor’s Degree in Computer Science, Information Systems, Business, or related field

· Lean Six Sigma or equivalent training

3. Preferred Licenses

· N/A

4. Preferred Certifications

· CPHQ (Certified Professional in Healthcare Quality)

· PMP (Project Management Professional)

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

LEVEL 1 · Act as lead segment analyst for large or complex Initiatives/Mandates/Projects/Enhancements under the direction of segment leadership

· Develop complex (e.g., multiple departments/systems) business requirements on large efforts and flow specifications with little to no management direction

· Decompose high-level project information and evaluates project components to forecast work effort required

· Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency, and completeness

· Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements

· Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities

· Resolve differences between customers and other team members to achieve organizational and project goals

· Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business

LEVEL 2 · Supports Segment with Enterprise level activities including but not limited to, Business, IT Sponsors and Project Managers, Vendor Management, and Risk/Issue Identification and Resolution

· Act as lead segment analyst for large or complex Initiatives/Mandates/Projects/Enhancements

· Ensures Service Level Agreements between department and operational or technical areas are met

· Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals

ALL LEVELS · The position requires a full-time work schedule (at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements).

COMPETENCIES

REQUIRED COMPETENCIES

1. Required Job Skills

· Basic skills with MS products, including Sharepoint, Excel, Word, Visio, and PowerPoint

· Excellent verbal and written communication skills and the ability to interact professionally and maintain positive working relationships in a cross-functional team environment

· Strong analytical skills in support of independent or team-based decisions utilizing customer input and research

· Strong problem-solving skills

· Strong time management skills

· Design, measure, reporting of key performance metrics for the Commercial Segment

· Basic understanding of the following Business areas:

· Customer Service including all intake channels

· Claims Adjudication for all lines of business

· Provider Contracting and Networks

· Knowledge of systems and processes for various BCBSAZ Lines of Businesses, including Local, CHS, Bluecard Home/Host and Medicare Advantage

2. Required Professional Competencies

· Ability to prioritize tasks and work on multiple priorities, sometimes under strict and competing time constraints

· Ability to build synergy with a diverse team in an ever-changing environment

· Ability to exercise independent judgment and demonstrate creative problem solving techniques

· Ability to anticipate downstream impacts and factor in those considerations appropriately

· Ability to persevere in the face of resistance or setbacks

3. Required Leadership Experience and Competencies

· Ability to support and execute on the priorities and direction of segment leadership

· Ability to apply sound decision-making skills to perform effectively in the absence of direction

· Ability to effectively deal with conflict

· Ability to present concepts effectively to varying levels of staff

PREFERRED COMPETENCIES

1. Preferred Job Skills

· Advanced skills with MS products, including, Sharepoint, Word, Visio, and PowerPoint

· Advanced data analysis and reporting skills using Excel, Access, Tableau or SAS

· Advanced understanding of Project Management, Program Management, and Analysis

· Strong facilitation and presentation skills

· Ability to develop and implement solutions on behalf of the internal/external client and organization that result in win/win outcomes

· Advanced understanding of the following Business areas:

· Enrollment

· Configuration

· Claims and Customer Service

· Provider Contracting and Networks

· Appeals & Grievances, Utilization Management, and Care Management

· Web Portals (Public, Member, Provider, Broker and Group)

2. Preferred Professional Competencies

· Ability to support any project or initiative as a utility player, especially in situations where the team/project is either under-staffed or missing the required roles/skillsets due to resource deficiencies

· Ability to develop solutions that meet the needs of internal and external customers that are in line with project and corporate strategic goals

· Ability to work with ambiguous and conflicting information while remaining focused on the end goal.

3. Preferred Leadership Experience and Competencies

· Ability to develop and present recommendations to leadership that affect the direction and/or success of the project or initiative

· Ability to proactively identify and manage risks (including the development of mitigation plans) before the risks manifest into issues

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.