Principal Facets Application System Analyst

Blue Cross and Blue Shield of North Carolina; Durham (CA); Hybrid; USD 119,000 - 190,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k with company match

Tuition reimbursement

Job summary

Blue Cross and Blue Shield of North Carolina is seeking an experienced Senior Business Analyst to lead end-to-end requirements elaboration and functional design for enterprise-wide solutions. This role is based in Durham and follows a Hybrid-Flex approach, enabling remote work with in-person collaboration.

You will collaborate with business clients and technology partners to translate needs into actionable designs, ensure quality, and mentor junior staff while navigating complex processes across

Qualifications

• Bachelor’s degree or advanced degree.
• 8+ years of experience in related field.
• In lieu of degree, 10+ years of experience.
• Trizetto Facets enrollment, billing and /or claims required.
• Strong knowledge with payer systems and enrollment functions, processing and automation.

Responsibilities

• Facilitate and influence the design, construction, deployment, and ongoing maintenance of complex technical solutions.
• Elaborate business requirements into functional designs and translate into system function points.
• Conduct systems analysis to validate designs and ensure alignment with Enterprise Architecture.
• Prioritize requirements through negotiation and project management techniques.
• Create and document functional designs of business solutions with end-to-end traceability.
• Maintain detailed knowledge of systems and processes for broad enterprise solutions.
• Serve as an expert advisor for systems analysis and process design services.
• Provide consultancy to business partners on applicable technology options.
• Review documentation to ensure end-to-end quality of the product.
• Support program goals by decomposing projects into multiple releases.

Skills

Requirements gathering

Payer systems knowledge

Education

Bachelor’s degree or advanced degree

Tools

Trizetto Facets

Job description

Job Description

Responsible for the end to end completion of requirements elaboration and system functional design to solution the most complex enterprise-wide business demands through enabling technology and/or business processes that impact multiple business units, lines of business, processes, and/or multi-project portfolio. Discern true business needs, facilitate work sessions; document, elaborate and prioritize requirements and specifications; and manage scope as input to functional, architectural and technical design. Ensure the quality, cost effectiveness, and timeliness of key business services and regulatory requirements or mandates via integrated enterprise solutions. Work directly with both business clients and cross domain technology partners to translate relevant enterprise business requirements into technical solutions via functional design.

WhatYou’llDo

• Facilitate and influence the design, construction, deployment, and ongoing maintenance of specific complex technical solutions through design documents, gap analysis, business rule and data mapping management, risk assessment, traceability mapping and financial and timeline constraints to balance ROI.
• Elaborate business requirements, rules, and data elements into functional designs that are both complex in nature and enterprise oriented. Applicable business requirements and processes are reviewed, analyzed, and translated into system function points.
• Conduct systems analysis to validate designs. Perform or facilitate reverse engineering of code when required. Create functional designs that meet systems analysis standards and are aligned with the Enterprise Business Process Architecture.
• Prioritize requirements through negotiation, release and phase management techniques and systems analysis techniques and tools.
• Create and document functional designs of business solutions. Ensure end-to-end traceability through appropriate artifacts. Determine and manage enterprise wide, upstream and downstream system impacts of proposed changes and enhancements.
• Maintain and utilize detailed system, application, and component analysis and design knowledge related to the construction of broad based and highly complex solutions, which requires detailed knowledge of the processes, technologies, and people components.
• Serve as a trusted, expert advisor or a Subject Matter Expert for systems analysis and process design services.
• Provide consultancy and advice to business partners on the applicability and usability of alternative technology to help address business requirements, problems or issues.
• Review documents and models produced by Business Analysts, Architects, and Developers to ensure end to end quality of the product.
• Support program and portfolio management goals through assessment of business solutions for decomposition of projects into multiple production releases to meet business owner needs. Recognize and manage technical synergies and conflicts across concurrent project activity.
• Participate in the development and support of scope and implementation strategies, including definition, development, and planning of incremental or iterative phasing for design, construction and implementation.
• Interpret and translate impacts, risks, and gaps across technical and non-technical audiences to ensure a holistic understanding of business and user requirements.
• Coordinate work of teams to effectively define, analyze, and develop enterprise solutions.
• Lead and mentor less experienced staff to influence the maturation of the practice.

What You Bring

• Bachelor’s degree or advanced degree (where required)
• 8+ years of experience in related field.
• In lieu of degree, 10+ years of experience in related field.
• Trizetto Facets enrollment , billing and /or claims required.
• Strong knowledge with payer systems and enrollment functions, processing and automation.

**Bonus Points**

• Proven experience migrating enrollment platforms and supporting end-to-end deployment activities.
• EDI 834 experience preferred but not required.

WhatYou’llGet

• The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community
• Work-life balance, flexibility, and the autonomy to dogreat work
• Medical, dental, and vision coverage along withnumeroushealth and wellness programs
• Parental leave and support plus adoption and surrogacyassistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Learn more

Where You’ll Work

Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.

In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$118,691.00 - $189,906.00

Skills

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