Internal Business Systems Consultant

Allegheny Clinic; Pennsylvania; Hybrid; USD 90,000 - 120,000; Full time

Job summary

Highmark Inc. is seeking a seasoned business analyst to support stakeholders, analyze requirements, and drive quality solutions across healthcare applications.

You will guide project lifecycles, ensure compliance, and mentor junior resources while interfacing with business and technical teams. The role emphasizes process improvement, strategic thinking, and strong communication, with travel 0%–25% and an office-based work environment in Pennsylvania.

Qualifications

• Required: 7 years in a relevant operational area (e.g. customer service, claims, enrollment and billing)
• To Include: 5 years of technical application experience
• Preferred: 5 years in the Health Insurance Industry
• 5 years in the Healthcare Industry
• 5 years with Lean Six/Sigma

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.
• 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.
• 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.

Skills

Leadership

Process Improvement

Analytical Skills

Problem-Solving

Communication Skills

Presentation Delivery

Customer Service

Strategic Thinking

SAS

Education

High School Diploma/GED

Bachelor's Degree in Information Systems

Bachelor's Degree in Business Administration

Bachelor's Degree in Business Management

Tools

SAS

Job description

Company : Highmark Inc. Job 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.

EDUCATION

• Required: High School Diploma/GED
• Substitutions: None
• Preferred: Bachelor's Degree in Information Systems, Business Administration or Business Management

EXPERIENCE

• Required: 7 years in a relevant operational area (e.g. customer service, claims, enrollment and billing, etc.)
• To Include: 5 years of technical application experience
• Preferred: 5 years in the Health Insurance Industry
• 5 years in the Healthcare Industry
• 5 years with Lean Six/Sigma

LICENSES AND CERTIFICATIONS

• Required: None
• Preferred: (Lean) Six Sigma
• Project Management Professional (PMP)

SKILLS

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

Preferred Skills:

• SAS

Language (Other than English)

• None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type: Office-Based

• Teaches / trains others regularly: Frequently
• 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: Constantly
• Lifting: 10 to 25 pounds: Never
• Lifting: 25 to 50 pounds: Never

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 job 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 both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company.