Overview

Functions at the most senior level Business Systems Analyst role. Works directly with senior management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative solutions to meet those needs. Gathers requirements, performs analysis, designs new or enhanced systems to meet operational, business and clinical needs. Acts as lead Business Systems Analyst on team; coordinates exchanges of knowledge and ideas, and mentors business systems analysts in all phases of the project lifecycle to ensure that best practices and standards are followed. Collaborates with Business Unit and/or Project Manager on assigned projects. Works under general supervision.

Compensation Range:$93,400.00 - $116,800.00 Annual

What We Provide

 

• Referral bonus opportunities     
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays   
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability    
• Employer-matched retirement saving funds   
• Personal and financial wellness programs    
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care   
• Generous tuition reimbursement for qualifying degrees   
• Opportunities for professional growth and career advancement    
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities     

What You Will Do

• Serves as primary technical expert and principal designer of information systems for the managed healthcare business. Collaborates with senior level management to understand business needs and challenges, and to develop, design, plan, and deliver information systems solutions to meet managed care payor needs.
• Functions as lead Business Systems Analyst on team. Works independently on most deliverables. Works in partnership with senior leadership and training department to ensure successful delivery of project objectives.
• Develops business case and ROI models to support user requests, coordinates with business leadership, finance and IT leadership as necessary. Performs high level product research relating to build/buy decisions.
• Gathers requirements from cross-organizational groups, including policy makers, leadership, business, clinical and IT staff for new development and/or enhancements of Clinical System and related applications. Includes participation in a build/buy analysis and gathering requirements for a vendor application selection.
• Analyzes requirements, workflow and consequences of system changes, and recommends changes to address deficiencies. Develops design for new and/or enhanced systems for all platforms (Tablet, Mainframe, Web).
• Writes requirements, functional specifications, report or metrics specifications, and other supporting documentation for new and/or enhanced systems. Produces documentation suitable for business clients, programmers, QA and trainers.
• Ensures that new or enhanced aspects of clinical systems are in compliance with state and federal regulations.
• Informs department manager and project manager of project progress and problems and ensures that these problems are reviewed and resolved prior to implementation.
• Participates in all phases of the project lifecycle and ensures that standards are followed and the systems developed or modified are adequately tested or documented. Advises on testing procedures and documentation, training methods and curriculum, implementation and conversion planning.
• Participates in standardizing formats and methodologies for requirements, functional specifications and system documentation. Monitors developments in the industry and helps bring best practices to the department.
• May mentor and coach less experienced Business Systems Analyst staff; coordinates exchange of knowledge, ideas and methods, and iRise best practice; advises analysts on developing specifications to ensure completeness and accuracy.
• Models existing undocumented systems; works with analyst team to build library of documentation and makes it available to the team. Teaches modeling methods and helps advance the knowledge and expertise of the group.
• May perform other leadership roles including team building, staff training specific to business analysis, on boarding and support of new hires.
• Coordinates with Operations Team in the development of educational training materials, user procedure manuals and user testing. Prepares reports on pre-test and post-test results to address deficiencies and educates team members and trainers on content.
• Maintains analysts’ library of resources. Develops library of pertinent books and articles on information systems for the department.
• For Claims Only:
• Develops and distributes regular management reports and any requests for special, ad hoc reporting or claims data. Develops positive working relationships with VNS Health Plans leadership.
• Develops an understanding of VNS Health Plans strategic business objectives and business unit operations, along a particular health plan value stream. Articulates business issues and designs data collection methodologies.
• Provides data collection and analytical support to team and monitors projects led by Service Operations team. Summarizes, creates, and distributes reports as needed.
• Visualizes data in creative ways to enhance understanding and accelerate decision making.
• Assists in writing reports, memos and other communications as needed. Coordinates report production as needed. Creates and implements dashboards with key performance indicators and forecasting models.
• Participates in interdepartmental work groups in support of process improvement projects, as needed.
• Assists in the design and delivery of presentations on project status and outcomes to management.
• Monitors new and existing process designs to measure operational effectiveness.
• Provides financial impact analysis for all retro compensation grids as a result of amendments or new published state rates.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education:

• Bachelor's Degree Computer Science, MIS, Information Technology, or Communications Engineering required

Work Experience:

• Minimum five years experience with responsibility for end-to-end SDLC design, development and implementation of managed healthcare payor solutions, (or two years of this experience plus a Master’s Degree in one of the above-required fields) required
• At least one year of experience must be with a managed care organization on business transformation required
• All candidates must have two years experience using FACETS, SQL scripts & queries, OBIEE, Power BI, Tableau & MicroStrategy reports & dashboards; project management & SDLC methodologies, with contracting and new business management across relational databases, using Oracle, SQL Server & DB2, managing stakeholder expectations and providing HIPAA-compliant guidance to business partners, vendors, and end-users, per industry standards for EDI protocols. Strong command of Microsoft Office Tools (Word, Excel, Visio, and PowerPoint) required, and mobile computing platforms & web- based technologies required
• Effective oral and written communication skills, consulting and analytical skills and ability to work with clients, IT management, staff, consultants and vendors required
• Ability to function autonomously, and collaborate with most senior level leaders across the agency required
• Claims Only:
• Minimum one year work experience in consulting, operations or financial analysis, Claims analytics or related discipline required
• Proficient with personal computers, including Microsoft Windows Excel, Word, Access, Power Point, Facets and (Altruista) Guiding care required
• Demonstrated understanding of NYS, CMS and Medicaid reimbursement guidelines. APG, APC, DRG preferred