Job description

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. Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. • 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. • Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology. • Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget. Ensure all system development lifecycle processes and standards are followed. • Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications. • Provide analytical support related to business applications, infrastructure and technology related activities. • May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries. • Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems. • Develop system solutions by preparing and evaluating alternative workflow solutions. • Perform release management and end to end testing of system changes. • 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. • Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s). • Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement. • Develop process requirements and recommendations and communicate for the implementation of technical business solutions. • Design and develop reports and data delivery to accommodate changing business requirements. • Investigate, resolve and escalate problems. • Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements. • Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members. QUALIFICATIONS • Bachelor’s degree in related field preferred. • Three (3) years of relevant technical or business work experience required. • Experience in managing cross functional teams or projects required. • Advanced knowledge preferred in system development life cycle, process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL, and computer programming languages. • Basic knowledge of business operations and systems requirement processes. • Strong technical, analytical, systems skills. • Display innovation in identifying, proposing, and overseeing the execution of business solutions. • Written and verbal communication skills; interpersonal skills. • Ability to provide technical or business guidance to clients, both internal and external. • Ability to work independently, or within a team environment. • Other related skills and/or abilities may be required to perform this job. Departmental Preferences: • Five (5) years of experience in healthcare operations, business analysis, payment integrity, provider reimbursement, claims administration, dispute resolution, project implementation, or a related field is preferred. • Demonstrated ability to analyze business processes, identify operational risks and opportunities, and develop practical solutions to improve effectiveness and efficiency is preferred. • Experience developing and maintaining business requirements, process documentation, operating procedures, workflows, job aids, and reporting requirements is preferred. • Strong analytical, organizational, and problem-solving skills with the ability to manage multiple priorities in a fast-paced environment is preferred. • Experience collaborating with cross-functional stakeholders and external vendor partners to support operational execution, issue resolution, and process improvement initiatives is preferred. • Experience supporting business readiness, testing, implementation, and change management activities is preferred. • Experience working with dispute resolution processes, provider negotiations, vendor management, or regulatory compliance activities is preferred.

Requirements

Must-haves

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.
Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology.
Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget. Ensure all system development lifecycle processes and standards are followed.
Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications.
Provide analytical support related to business applications, infrastructure and technology related activities.
May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries.
Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems.
Develop system solutions by preparing and evaluating alternative workflow solutions.
Perform release management and end to end testing of system changes.
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.
Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s).
Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement.
Develop process requirements and recommendations and communicate for the implementation of technical business solutions.
Design and develop reports and data delivery to accommodate changing business requirements.
Investigate, resolve and escalate problems.

Nice-to-haves

Bachelor’s degree in related field preferred.
Advanced knowledge preferred in system development life cycle, process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL, and computer programming languages.
Five (5) years of experience in healthcare operations, business analysis, payment integrity, provider reimbursement, claims administration, dispute resolution, project implementation, or a related field is preferred.
Demonstrated ability to analyze business processes, identify operational risks and opportunities, and develop practical solutions to improve effectiveness and efficiency is preferred.
Experience developing and maintaining business requirements, process documentation, operating procedures, workflows, job aids, and reporting requirements is preferred.
Strong analytical, organizational, and problem-solving skills with the ability to manage multiple priorities in a fast-paced environment is preferred.
Experience collaborating with cross-functional stakeholders and external vendor partners to support operational execution, issue resolution, and process improvement initiatives is preferred.
Experience supporting business readiness, testing, implementation, and change management activities is preferred.
Experience working with dispute resolution processes, provider negotiations, vendor management, or regulatory compliance activities is preferred.

Application prep

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Platform: oracle-cloud
Effort: medium