Shared Savings Business Analyst

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: analysis,organization,business analysis,application development,systems analysis,process improvements,performance,preferred skills,knowledge,experience,skills,education


Competitive Total Compensation Package

Overview: <p><strong>Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures. &nbsp;Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives.&nbsp;<span>Design, create and implement technical solutions.</span></strong><strong><span><span>&nbsp;Support complex business processes.</span></span></strong></p>
Responsibilities: <p><strong>Business Analysis</strong></p> <ul> <li>Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction.</li> <li>Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology.</li> </ul> <p><strong>Application Development</strong></p> <ul> <li>Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget.</li> <li>Ensure all system development lifecycle processes and standards are followed.</li> <li>Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications.</li> <li>Provide analytical support related to business applications, infrastructure and technology related activities.</li> </ul> <p><strong>Systems Analysis</strong></p> <ul> <li>May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries. Discuss users&rsquo; needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems.&nbsp;Develop system solutions by preparing and evaluating alternative workflow solutions.</li> <li>Perform release management and end to end testing of system changes.</li> <li>Identify, investigate, resolve and escalate problems a needed. Gather data to support recommendations to address problems. Procure additional technical assistance to help in problem resolution.</li> </ul> <p><strong>Process Improvements</strong></p> <ul> <li>Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s).</li> <li>Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement.</li> <li>Develop process requirements and recommendations and communicate for the implementation of technical business solutions.</li> </ul> <p><strong>Other Duties and Responsibilities</strong></p> <ul> <li>Design and develop reports and data delivery to accommodate changing business requirements.&nbsp;Investigate, resolve and escalate problems.</li> <li>Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements.</li> <li>Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members.</li> <li>Other duties may be assigned.</li> </ul>
Requirements: <ul> <li>Bachelor's degree in related field preferred.</li> <li>Five (5) years of relevant technical or business work experience required.</li> <li>Experience in managing cross functional teams or projects required.</li> <li>Advanced knowledge preferred in: <ul> <li>System development life cycle</li> <li>Process design, re-engineering, and organization transformation, Six Sigma, CMMI&nbsp;or ITIL&nbsp;computer programming languages</li> </ul> </li> <li>Strong technical, analytical, systems skills.</li> <li>Display innovation in identifying, proposing, and overseeing the execution of business solutions.</li> <li>Written and verbal communication skills interpersonal skills.</li> <li>Ability to provide technical or business guidance to clients, both internal and external.</li> <li>Ability to work independently, or within a team environment.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <p><strong><u>Department Summary and preferred skills</u></strong></p> <p>Responsible for product support to&nbsp;areas and resources engaged&nbsp;in implementation and sales efforts associated with the payment integrity Shared Savings products. This includes the following:</p> <ul> <li>Support business readiness and the claims/sales operational support necessary to achieve product launch and efficient operational performance.</li> <li>Provide product expertise to sales operations and customer support processes associated with customer adoption and on-going use of claims payment integrity Shared Savings products.</li> <li>Act as a liaison to designated functional areas engaged in the planning, delivery and support of&nbsp;claims payment integrity Shared Savings products.</li> <li>Consult with and as required deliver the tools and activities required to support marketing, selling and customer support efforts specifically directed toward&nbsp;Shared Savings products.</li> <li>Occasional promotional support of sales operations and field Salesforce efforts associated with the explanation of the products value proposition and how those results can be tracked and reported upon post-sale.</li> <li>As required through the interface with Sales Operations, provide product support for sales Request for Information (RFI), Request for Proposal (RFP) and FAQ.</li> <li>Identify sales operations team members (and others) who typically provide BCBSM product support to field sales organization, and as required deliver payment integrity Shared Savings product in-servicing for knowledge transfer.</li> <li>Develop payment integrity &ldquo;Product Info Sheets&rdquo; that explain how value is derived by the application of each product with specific claim adjudication examples.</li> <li>Knowledge of health insurance business capabilities and operational processes.</li> <li>Minimum two (2) years previous payment integrity, product or program management experience preferred.</li> <li>Knowledge of health insurance claims adjudication process and payment integrity systems and methods.</li> <li>Excellent analytical, organizational, verbal, written and presentation communication skills.</li> <li>Experience with the following product support standards and functions: <ul> <li>Stakeholder expectations management.</li> <li>Issue management.</li> <li>Product performance and value outcome monitoring and reporting management.</li> <li>Creation and maintenance of product documentation, tools and presentation materials.</li> <li>Promotional support of sales operations and field Salesforce.</li> </ul> </li> <li>A high proficiency level in specific job-related skills is required.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul>