Internal Business Systems Consultant

Highmark Inc; Pennsylvania; Hybrid; USD 86,000 - 139,000; Full time

Job summary

Highmark Health is seeking a senior business analyst to support stakeholders for a system application(s). You will capture capability needs, drive quality solutions, and lead project lifecycles while mentoring junior teammates.

Emphasis on understanding user workflows, system integration, and regulatory compliance. Qualifications include 7 years in relevant operations, 5 years in technical applications, and preferred Lean Six/Sigma.

Qualifications

• 7 years in a relevant operational area (e.g. customer service, claims, enrollment and billing).
• 5 years of technical application experience.
• Preferred 5 years in Health Insurance or Healthcare Industry and 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.
• 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.
• Take lead role in supporting various aspects of requirements testing 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

Bachelor's degree in Information Systems/Business Admin/Business Management

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’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range

Minimum: $86,400.00 Maximum: $138,600.00 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.

EEO Statement

Highmark 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.

Company Information

Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which includes Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.