Job Details

Job Location Smithfield, RI - Smithfield, RIPosition Type Full TimeEducation Level Bachelors DegreeTravel Percentage NoneJob Shift DaytimeJob Category Professional / Experienced

Description

This position is responsible for the development and oversight of technical system requirements, report configuration, research and root cause analysis, management, communication and escalation of Application Support defects for core systems as needed. He/she will also provide analytical and data support to the operational business areas in order to maximize the departments ability to make data driven decisions and meet regulatory requirements. This role requires strong communication and analytical skills and an understanding Health Plan Operations.

Serve as a subject matter expert to the technical functions of the core systems
Manage the application support process for service requests, issues and enhancements
Understand and communicate the Core product road map and manage system enhancements
Serve as a resource in facilitating the gathering of submission data from delegated entities
Manage a range of moderate to complex activities involving data analysis
Perform Data and Statistical Analysis
Contribute to development of technical requirements, functional requirements, process flows, reference materials, user guides and code release artifacts as appropriate.

Duties And Responsibilities:

Responsibilities include, but are not limited to the following:

Acts as a liaison between department and technical groups
Serves as a resource in facilitating the gathering of business requirements and test cases as well as coordinating and documenting
Performs business process mapping and documentation
Understands operational processes within the business area
Identifies and advocates for opportunities to bring additional IT value to the business area
Works with key project stakeholders to formulate and communicate business requirements and scope of projects
Works with project stakeholders to translate requirements into specifications that technical staff can understand, translate questions the technical staff has into a format that stakeholders can understand
Validates stakeholder requirements
Writes use cases as part of the requirements document
Identifies potential areas of automation and aid in re-engineering underlying business processes
Assists in developing and maintaining standards for development of business processes and documentation
Other duties as assigned
Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications

Required:

Bachelors degree and/or years of experience and background to equate to the degree
Three (3)+ years experience relating to health plan data operations, system configuration and reporting
Three (3)+ years of related business analysis/data analysis experience
Proficient in the use of analytical tools such as Cognos, SQL and Crystal Reports
Strong attention to detail
Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively at all levels of management
Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates
Adept in problem solving and resolving conflict
Proficient in MS Project, Excel, PowerPoint and Word, Visio
Ability to liaise with business users, developers, stakeholders, analysts and management.
Strong communication skills, both verbal and written
Must have outstanding time management and organizational skills
Must be a self-starter and able to work with minimum supervision
Solid organization, negotiation, and analysis skills with demonstrated ability to deliver on multiple assignments meet tight deadlines and are effective and decisive under pressure.

Preferred:

IIBA Business Analysis Certification
Extensive experience in an insurance, medical and/or HMO environment using claims processing software
Two (2)+ years of defect management experience
Experience in demonstrating leadership, influence and collaboration in a matrix-managed environment

Salary Grade: G/T

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