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Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures. Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes.

  • Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction.
  • Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology.
  • Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget. Ensure all system development lifecycle processes and standards are followed.
  • Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications.
  • Provide analytical support related to business applications, infrastructure and technology related activities.
  • May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries.
  • Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems.
  • Develop system solutions by preparing and evaluating alternative workflow solutions.
  • Perform release management and end to end testing of system changes.
  • Identify, investigate, resolve and escalate problems a needed. Gather data to support recommendations to address problems. Procure additional technical assistance to help in problem resolution.
  • Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s).
  • Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement.
  • Develop process requirements and recommendations and communicate for the implementation of technical business solutions.
  • Design and develop reports and data delivery to accommodate changing business requirements.
  • Investigate, resolve and escalate problems.
  • Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements.
  • Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members.

QUALIFICATIONS

  • Bachelor’s degree in related field preferred.
  • Three (3) years of relevant technical or business work experience required.
  • Experience in managing cross functional teams or projects required.
  • Advanced knowledge preferred in system development life cycle, process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL, and computer programming languages.
  • Basic knowledge of business operations and systems requirement processes.
  • Strong technical, analytical, systems skills.
  • Display innovation in identifying, proposing, and overseeing the execution of business solutions.
  • Written and verbal communication skills; interpersonal skills.
  • Ability to provide technical or business guidance to clients, both internal and external.
  • Ability to work independently, or within a team environment.
  • Other related skills and/or abilities may be required to perform this job.

Departmental Preferences:

  • Five (5) years of experience in healthcare operations, business analysis, payment integrity, provider reimbursement, claims administration, dispute resolution, project implementation, or a related field is preferred.
  • Demonstrated ability to analyze business processes, identify operational risks and opportunities, and develop practical solutions to improve effectiveness and efficiency is preferred.
  • Experience developing and maintaining business requirements, process documentation, operating procedures, workflows, job aids, and reporting requirements is preferred.
  • Strong analytical, organizational, and problem-solving skills with the ability to manage multiple priorities in a fast-paced environment is preferred.
  • Experience collaborating with cross-functional stakeholders and external vendor partners to support operational execution, issue resolution, and process improvement initiatives is preferred.
  • Experience supporting business readiness, testing, implementation, and change management activities is preferred.
  • Experience working with dispute resolution processes, provider negotiations, vendor management, or regulatory compliance activities is preferred.

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