Senior Systems Analyst

Blue Cross & Blue Shield of Rhode Island; United States; Hybrid; USD 94,000 - 140,000; Full time

Benefits offered by this job

Remote and hybrid opportunities

Tuition reimbursement

Student-loan repayment assistance

Health, dental, vision insurance

Paid time off

Volunteer time off

Job summary

Blue Cross & Blue Shield of Rhode Island seeks a Senior Systems Analyst to analyze complex technical issues, define technical requirements, and guide systems modifications that align with business strategy. You will translate business needs into technical solutions and mentor analysts across IT teams.

You will participate in requirements sessions, review vendor specifications, and support healthcare payor adjudication systems.

Qualifications

• Bachelor’s degree in Computer Science, Information Systems, Business, or Engineering.
• Five to seven years of systems analysis experience in key business processes.
• Experience with Facets or other healthcare payor adjudication systems.
• Experience with NetworX Pricer or other healthcare claims pricing engine.
• Experience with provider agreements, facility claim adjudication, service and procedure code setup.
• Experience with groupers and editors such as 3M or Optum.
• Healthcare or insurance experience.
• Experience with Cloud based platform integrations: Azure, Google and Salesforce.
• Experience with waterfall and agile software development methodologies.

Responsibilities

• Participate in business requirements sessions to define technical requirements.
• Gather technical requirements, document findings, and incorporate feedback.
• Translate business needs into technical requirements.
• Formulate and define technical scope to align with business objectives.
• Map business data elements to backend data sources.
• Mentor technical analysts in defining and documenting requirements and roadmaps.
• Lead reviews of vendor technical specifications and documentation.
• Provide expert advice to technical staff and contribute to improving operational processes.

Skills

Analytical thinking

Communication skills

Strategic thinking

Problem solving

Negotiation skills

Time management

Organizational skills

Education

Bachelor’s degree in CS/IS/Business/Engineering

Tools

Facets

NetworX Pricer

Azure

Google Cloud

Salesforce

Job description

Pay Range: $93,600.00 - $140,400.00 At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard‑working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student‑loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well‑being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We’re dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high‑quality, affordable, and equitable care. To further improve the health and well‑being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

Why this job matters: Analyze complex technical issues and identify projects and technologies which will produce significant operational results and add value to the corporation. Conduct business requirements reviews and independently formulate logical statements of business requirements. Formulate and define technical scope to align with business objectives based on both user needs and technology strategy. Develop technical system specifications, resources and processes for a complex sub‑systems or major systems modification.

What you will do:

• Participate in business requirements sessions to define technical requirements.
• Gather technical requirements, ask probing questions, document findings, and incorporate feedback.
• Translate business needs into technical requirements.
• Formulate and define technical scope to align with business objectives based on both user needs and technology strategy.
• Analyze and revise existing system logic difficulties.
• Partner with business process experts to learn and understand problems or required changes with software.
• Develop detailed selection evaluation criteria based on identified IT product requirements.
• Assume leadership role in defining technical requirements and solutions.
• Create and/or assist in the creation of technical documentation that describe how systems should be created/modified to meet business requests.
• Review and approve the designs of vendors who create these types of documents.
• Map business data elements to backend data sources.
• Mentor technical analysts in methodology for defining and documenting technical requirements and defining technology roadmap.
• Participate in functional specification and design reviews, validating technical aspects.
• Offer expert advice to technical staff.
• Provide innovation to business areas and contribute to improve operational processes by advising in technical expertise.
• Review and sign off on vendor delivered technical specifications.
• Mentor less experienced staff.
• Lead department projects and initiatives.
• Perform other duties as assigned.

What you need to succeed:

• A combination of education and related work experience
• Experience creating technical documents
• Knowledge of implementation and conversion activities
• API and batch system expertise
• Knowledge of modern web‑based application design and client server technology
• Strategic and critical thinking skills
• Strong analytical skills
• Strong business acumen and political savvy
• Strong negotiation skills
• Strong written and verbal communication skills
• Strong problem‑solving skills
• Ability to work effectively with a wide variety of people in individual and group settings.
• Strong organizing skills, with the ability to prioritize and respond to shifting deadlines.
• Strong time management skills
• Ability to manage diverse and deadline‑oriented workflow.

The extras:

• Bachelor’s degree in Computer Science, Information Systems, Business, or Engineering; or an equivalent combination of education and applicable work experience
• Five to seven years of systems analysis experience, working on key business processes to define technical requirements.
• Experience with Facets or other healthcare payor adjudication systems.
• Experience with NetworX Pricer or other healthcare claims pricing engine.
• Experience with provider agreements, facility claim adjudication, service and procedure code setup.
• Experience with groupers and editors such as 3M or Optum.
• Healthcare or insurance experience.
• Experience with Cloud based platform integrations: Azure, Google and Salesforce.
• Experience with waterfall and agile software development methodologies.

Location:

• BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal.
• We actively support associate well‑being and work/life balance and offer the following schedules, based on role:
• In-office: onsite 5 days per week
• Hybrid: onsite 2‑4 days per week
• Remote: onsite 0‑1 days per week
• Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia.

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.