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Systems Analyst, Senior

Company: Blue Shield of California
Location: El Dorado Hills
Posted on: September 17, 2020

Job Description:

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than 20 billion in annual revenue and 4.3 million members. The company has contributed more than 500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us Description The Senior Business Systems Analyst, IT Applications will be responsible for managing Department's project portfolio, solution design, development and delivery of EDIApplications solution for Enrollment, Claims, Encounters, business processes and support complex business applications. HeShe will work collaboratively across business and IT functions to meet or exceed service level agreementobjectives and ensures on time delivery of solutions and automation. HeShe with limited oversight from manager, coaches, reviews and delegates work to developers. RESPONSIBILITIES bull Manage department's project portfolio, processes and Identifiesmanages risks bull Be the subject matter expert in the area of Products, EDI and workflow bull Provides analysis, support and guidance to both internal and external customers on projects and requests related to products, enrollment, claims, billing statements, payments and business workflow bull Influences others regarding policies, best practices and procedures related to products, enrollment, claims, billing statements, payments and business workflow bull Manage assigned project, on time development, design, and systems integration from initiation phase through implementation (SDLC) supporting business functions of Products, Enrollment, Claims, Encounters and EDI applications. bull Supports systems scope definition and objectives through research combined with an understanding of applicable business EDI systems and industry requirements. bull Determines needs capabilities and help with the business transformation project and department's roadmap. bull Works to achieve operational targets with major impact on the departmental results. Contributes to the development of goals for the department and planning efforts (budgets, operational plans, etc.). bull Influences the performance of the business unit or related functional areas in achieving Blue Shield of CA objectives. bull Responsible for making moderate to significant improvements of processes, systems or products to enhance performance of job area. bull Triage numerous and undefined issues, detailed information gathering, analysis and investigation to understand the problem that typically impacts multiple departments or specialties bull Monitor department's SLA around deliverables, project delivery, problem management vendor delivery, etc. Performs analysis on data and metrics for the department. bull Ensures quality assurance and HIPAA standards are rigorously followed to ensure EDI transactions are compliant with industry, company, legal and security standards. bull Perform Quality Acceptance Testing (QAT) and production business validation testing as needed. bull Ensure test case scenarios and scripts are ready to support QAT. bull Identify, document and test defects identified during QAT and validation testing. bull Supplier Management Identifies service needs, helps design services, helps oversee execution and performance of managed services, third party, vendor and development suppliers bull Other duties as assigned. Qualifications bull 5 year of knowledge of electronic data practices and techniques including business processes and systems analysis. bull 5 year of experience in healthcare claims. bull Expert Technical Knowledge and experience in all applications development, implementation and support (Architecture, requirements, developments, system design configuration, Datainformation conversion migration and system support). bull Working knowledge of health plan operations including enrollments and claim processing systems, billingpayment andor clearinghouse services. bull Good interpersonal, team, customer service and communication (verbal and written) skills. bull Good project management skills with attention to details. bull Understanding of health plan legal, brand, and regulatory compliance requirements. bull Requires practical knowledge of job area typically obtained through advanced education combined with experience. bull Typically, requires a college degree or equivalent experience and 3 years of prior relevant experience. bull Desired project management, business analysis or lean sigma certifications. bull Familiar with standard software development tools, including incident tracking, documentation, and testing systems bull Self-directed, works with limited management direction and exercise considerable latitude in determining technical objectives of assignment bull Ability to build strong relationships and drive alignment on difficult topics bull Familiarity with multiple software delivery models (Waterfall, Agile, etc.) Education bull A BABS or minimum 5 years of equivalent experience as business systems analyst in a related field such as EDI, business, management information systems, health care DicePost Physical Requirements Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home officedeskwork - Activity level Sedentary, frequency most of work day. Please click here for further physical requirement detail. External hires must pass a background checkdrug screen. Qualified applicants with arrest records andor conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Keywords: Blue Shield of California, Sacramento , Systems Analyst, Senior, Professions , El Dorado Hills, California

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