Business Process Analyst - Risk Adjustment

Highmark Health; Austin (TX); Remote; USD 50,000 - 92,000; Full time

Job summary

A healthcare company is seeking a Business Analyst to provide expertise in analysis and process improvements. This remote role requires 3-5 years of experience in a relevant field and offers a starting salary of $50,200 to $91,200. Duties include managing projects, gathering operational objectives, and facilitating process improvements.

Qualifications

• 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or in a related operational area.
• Experience in the Health Insurance Industry preferred.

Responsibilities

• Intake operational objectives and gather information.
• Coordinate, monitor, and report on project progress.
• Manage small to intermediate cross-functional projects.

Skills

Analysis of business problems/needs

Written & Oral Presentation Skills

Business Analysis

Business Process Design

Business Process Improvement

Business Process Mapping

Business Requirements

Collaborative Problem Solving

Project Management

Education

High School Diploma/GED

Bachelor's Degree

Job description

Overview

Company : Highmark Inc.

Job Description : JOB SUMMARY This job provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one or more operational areas. Identifies process gaps and recommends process improvements for efficiencies. May provide guidance to Associate level employees. This role sits within our Risk Adjustment team - it is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.

Experience and location This is a remote-based role within the Risk Adjustment team; experience with claims and familiarity with risk adjustment is preferred.

Responsibilities

• Intake operational objectives and gather information. May perform routine research and evaluate basic output requirements and formats. Communicate business operational requirements to internal groups responsible for developing/testing business requirements in various applications.

• Coordinate, monitor, and report on the progress of projects to ensure adherence to defined project schedule. Communicate effectively with customers and colleagues. Successfully articulate issues, problems, and solutions. Conduct pre-and post-implementation review. Assist in the planning/designing and facilitation of functional walk-throughs. May require additional support from more experienced team members.

• Manage small to intermediate cross-functional projects and change initiatives involved in the design and delivery of business process solutions, implementation strategies, and control measures, including scoping, leading, and influencing organizational change related to business processes and models.

• Facilitate process improvement meetings and/or discussions.

• Analyze the functions and operations of a business area/function and identify problem areas. Create process mapping and document current and future state business processes.

• Recommend process efficiencies, strategies for improvement, and/or solutions to align technology with business strategies.

• Assist in development of desktop procedures and/or training material.

• Other duties as assigned.

Education

• Required: High School Diploma/GED

• Substitutions: None

• Preferred: Bachelor's Degree

Experience

• Required: 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, customer service, etc.)

• Preferred: 1 - 3 years in the Health Insurance Industry

Licenses or Certifications

• Required: None

• Preferred: None

Skills

• Analysis of business problems/needs

• Written & Oral Presentation Skills

• Business Analysis

• Business Process Design

• Business Process Improvement

• Business Process Mapping

• Business Requirements

• Collaborative Problem Solving

• Project Management

Languages

None

Travel

0% - 25%

Physical, Mental Demands and Working Conditions

Position Type: Office-Based

Teaches / trains others regularly

Occasionally travel regularly from the office to various work sites or from site-to-site

Rarely Works primarily out-of-the office selling products/services (sales employees)

Never Physical work site required

Yes

Lifting: up to 10 pounds — Constant

Lifting: 10 to 25 pounds — Never

Lifting: 25 to 50 pounds — Never

Compliance and Notices

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with HIPAA and with the company’s privacy policies and information security policy, as well as the company’s Code of Business Conduct. This includes adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay

Pay Range Minimum: $50,200.00

Pay Range Maximum: $91,200.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

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 any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at [e-mail]

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J270079