Department: Claims Projects and Sys
Will not be required to come onsite.
Plan, develop, test and implement IT system solutions that improve business efficiency and productivity as well as support business strategies and goals. Identify and communicate business needs and translate business requirements into technical system and functional specifications. Support one or more highly complex or critical business processes/systems and may require design or integration of technical solutions that may cross multiple functions of the business. Project team member for projects large in scope and high complexity; may be enterprise-wide. Bachelor's degree in related field preferred. Five (5) years of relevant system solution development, testing and implementation work experience required.
Area specific needs-
The Claims Applications area is looking for a Systems Analyst III to join our team as a leased resource. Our department focuses on the process and payment of claims, managing ancillary products, association programs and vendor integrations. This resource will ensure effective and efficient onboarding and roll out of functionalities.
Departmental Summary:
• Basic functional knowledge in end-to-end claims processing
• Assist in troubleshooting system issues related to claims processing
• Attend industry standard work groups
• Working experience in collaborating with business users and quality analysis teams to ensure effective system integration and implementation
• Work experience in data analysis and validation
Departmental Preferences:
• Previous experience working with claims eligibility
• Familiarity of health care insurance systems
• Proficiency working with Excel
The Systems analyst III is responsible for helping business partners implement technology solutions by determining the requirements of a business unit, project, initiative, or program, and assisting teams in translating these requirements into user stories and features. The Systems Analyst III provides general analytical support across projects, initiatives, and business units, as well as the entire organization, and understands key business processes, key business drivers, short and long-term strategy, and related technologies. During development, the Systems Analyst III with issues and questions and provides support in implementing required changes. Additionally, the Systems Analyst III participates in planning and supports quality efforts.
Align technology solutions with business strategies comprised of moderate to complex business processes.
Work with business unit managers, project managers, agile teams, and business stakeholders to identify and capture business problems and non-functional requirements.
Clearly communicates the organization's options through the business case making full use of external research and industry-specific trends.
Develop materials and present results from pulled reports.
Translate business requirements and user stories into functionality and features.
Aid team in performing technological assessments and assist in developing recommendations based on business relevance, appropriate timing, and deployment.
Develop recommendations for resolution of problems and review recommendations with team.
Work closely with developers and end users to ensure technical compatibility and user satisfaction.
Assist in agenda setting and project prioritization efforts for planning sessions.
Serve as a key partner with business units, identify requirements and facilitate and manage requirements and user story discovery sessions and drive the development of session documentation.
Collaborate with team on systems and process automation planning to align with industry best practices and meet business / IT needs.
Coach employees to make use of technology and information when necessary.
QUALIFICATIONS
Bachelor's degree preferred. Or equivalent work experience.
Four (4) to six (6) years of relevant system solution development, testing and implementation work experience required.
In-depth knowledge of business operations, systems requirements, development methodologies, and IT processes and technologies.
Requires technical, analytical, and interpersonal skills.
Familiarity with standard and emerging IT processes, tools, and frameworks.
In-depth knowledge of the insurance industry (e.g., members, eligibility, claims, etc.).
Experience in eliciting requirements and performing testing.
Knowledge of Agile, DevSecOps, and Design Thinking Methodologies.
Experience translating customer journeys into user stories.
Knowledge of information gathering, planning, and organizing methods and principles.
Experience in analyzing data to draw business-relevant conclusions and in data visualization techniques and tools.
The ability to influence stakeholders and work closely with them to determine acceptable solutions.
Fundamental analytical and conceptual thinking skills.
Excellent planning, organizational, and time management skills.
Strong written and verbal communication skills including technical writing skills.
Ability to conduct research into a wide range of computing issues as required.
Ability to absorb and retain information quickly, specifically complex technical information.
Good understanding of the organization's goals and objectives.
Enthusiasm for working with technical teams producing complex solutions.
Applies original thinking to produce new ideas and innovate.
Desired technical skills Systems Development Life Cycle (SDLC), Structured Query Language (SQL), Quality Assurance (QA), Requirements Gathering, Functional Specifications, and Advanced Analysis.
Other related skills and/or abilities may be required to perform this job.
