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Business Systems Analyst Senior AOD

HealthPartners
medical insurance
Jan 09, 2025

HealthPartners is hiring Business System Analyst in AOD. They are responsible for business systems production support activities for multiple core health plan administrative systems (incentive management, membership, premium billing, claims, referral authorizations, or HRA/FSA administration) or other departmental surround applications. This role will participate in the implementation of system software fixes/enhancements aligned with defined business objectives, serving as project leader on small to midsize projects. They serve as a liaison between internal team members from assigned business operations and IS & T departments, as well as applicable system software vendors.

ACCOUNTABILITIES:

Knowledge Level:

Serves as a subject matter expert on multiple health plan administrative systems.

Possesses in-depth knowledge of assigned systems/business operation functions including: system functional capabilities, data interfaces to/from other applications, system outputs, database structures, business processes and procedures, applicable national medical code sets, and relevant federal and state regulatory requirements.

Knowledgeable in one or more federal HIPAA health plan transaction standards.

Production Support:

Update or audit assigned system dictionaries in a timely and accurate manner to support the accurate and timely processing of health plan administrative transactions.

Serve as a primary business systems production support contact and subject matter expert to assigned internal business operations department(s) for questions related to system functionality capabilities and reporting of potential systems issues.

Communicate timely and accurate responses to system capability inquiries.

Participate in the daily monitoring of multiple core administrative, departmental surround systems or system interfaces to and from other system applications. Evaluate assigned system outputs and daily performance results in effort to quickly identify potential system issues.

Through application of analytical skills, computer technology knowledge, and health plan business operations knowledge, identify potential opportunities to improve current automated or manual systems or processes or apply existing system capabilities to additional business operations.

Review improvement suggestions with Manager, business operations staff and IS & T or, if applicable, the system software vendor.

Perform necessary investigations related to reports of potential system issues. If issue is identified, develop problem resolution recommendation(s). This includes entry/maintenance of investigation information into systems tracking software.

Review investigation findings and, if needed, proposed problem resolution recommendation(s) with Manager, business operations staff, IS & T and, if applicable, the system software vendor.

Develop and distribute ad-hoc business reports through the use of an end user business reporting tool such as Business Objects.

Core Administrative System Fixes/Enhancements:

Serve as business systems project lead for implementation of small to midsize system enhancements/fixes*. Responsible for planning, organizing, scheduling and directing these initiatives. Responsible for project completion within expected budgetary, time, and staffing limits. Prepare project plan and status reports for management.

Serve as key team participant on large/complex systems fixes or development projects as assigned by AOD Management.

Create business requirements document for small to midsize system fixes/enhancements and obtains required business requirements sign-off from business operations and IS & T staff.

Review IS & T technical systems design recommendations to validate that system functionality is in alignment with business requirements.

Assists in the evaluation of potential operational impacts and works with business operations staff in identifying and documenting changes to current business workflows.

Develop systems testing strategy and test plan documents, including identification of required test scenarios and expected results. Review test plan with business operations staff to validate accuracy of test plan.

Conduct required business user system testing and, if needed, review results with business operations and IS & T contacts to obtain final user acceptance testing sign-off.

Work with IS & T and business operations staff to identify implementation tasks and schedule date for system fix/enhancement installation. Analysts may participate in the development of training manuals and train business users how to properly use system applications.

Develop post-implementation strategy and conduct monitoring to validate successful implementation of system fix/enhancement.

* Small to midsize system fixes/enhancements require less than 750 hours of IS & T programming time. Changes may affect multiple system applications and business departments across the health plan and development/implementation must be coordinated with all affected project constituents.

Other

Maintains excellent working relationships with internal business customers, IS & T team members, department team members, project sponsors, and applicable system software vendors.

Supports departmental and division team through participation in appropriate meetings and projects.

Position requires a high degree of initiative to manage priorities and identify opportunities for systems improvement and innovation. Responsible for continued professional development, including continuing education to ensure their systems and business operations knowledge is current.

Performs other duties and assumes projects as assigned by AOD Management team.

REQUIRED QUALIFICATIONS: (Minimum qualifications needed for this position)

Four or more year's general business experience or experience in medical insurance or health care setting including project planning and leadership experience with medium to complex level projects.

Familiarity with continuous quality improvement and system development methodologies.

Demonstrated analytical, facilitation, presentation and communications skills (oral & written).

Ability to deal with ambiguity and changing priorities.

Strong customer/client service orientation.

Ability to take responsibility for one's own performance and attitude on the job.

High degree of initiative.

PREFERRED QUALIFICATIONS:

Bachelor's degree in Health Care Management, Business Administration, Computer Science or related field, including computer science course work.

One-year professional or equivalent level experience with computer systems may be substituted for college level computer science or data processing course work.

Experience using MS Office applications, flowcharting tools, and/or other project management tools.

Experience in test plan development and execution.

One or more years of experience with continuous improvement concepts and methodologies.

Experience working with multiple HealthPartners core health plan administrative systems.

Experience with various electronic processes and systems including external and internal interfaces and system integration.

Fourth generation program language experience (e.g. SQL, Oracle Reports, Visual Basic, Business Objects, etc.).

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