Job Description

Under general supervision and utilizing solid functional/technical area knowledge of relevant systems/applications, the incumbent defines, evaluates, and validates requirements, business functional design, and technical design for small to moderately complex business issues within their domain areas. They act as a liaison representing their department and the processes and workings within it to develop effective technical solutions and minimize operational and system/application impacts. Supports IT with problem resolution, testing, software upgrades and related projects as needed.

What You'll Do

Technical Support/Business Expertise

• Provide technical knowledge and support in operational system/application and procedural issues to the business and IT and help the business find technical solutions to meet their goals.
• Work in some phases of systems analysis and consider the business implications of the application of technology to the current business environment
• Provide ongoing user support for ad hoc questions, inquiries, and service requests.
• Provide timely and accurate reporting/data on inventory, productivity, user activity, and system performance on a regular and/or as requested basis.

Issue Resolution

• Resolve medium, moderately complex production issues by:
  
  • Performing initial triage for severity and business impact of system/application failures.
  • Troubleshooting and analyzing to determine root cause of issues
  • Developing applicable business processes and solutions to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
  • Coordinating with IT, other teams and vendors as needed to communicate issues and devise and implement long term remedies.

• Develop system support processes with IT; coordinate daily to resolve production support issues, including application failures and user errors; document, track and report all system support activities

Project/Program Support

• Work collaboratively on projects and initiatives with the business and IT by eliciting and documenting business requirements and preparing appropriate functional specifications while considering technical capabilities of the system/application.
• May act as Business Lead/Coordinator on moderate single area/department projects.

Business Testing

• Coordinate testing plans with Business area and IT

• Serve as point of contact for business testing activities and ensure testing will appropriately meet business requirements
• Document and may, in some cases, execute test plans and scenarios
• Analyze and verify testing results for accuracy, relevance and completeness
• Provide impact assessments and make assist in formulating recommendations to the business owner regarding issues, risks, etc.

• Assist IT with hardware and software upgrades, security changes, and architectural enhancements as needed.

System Configuration

• Configure and maintain moderately critical system tables and data elements across multiple system environments
• Analyze, develop and implement configuration changes to improve system performance and user efficiency
• Monitor configuration for accuracy and compliance to change control processes.

What You Have

• Bachelor's degree or advanced degree (where required)
• 3+ years of experience in related field.
• In lieu of degree, 5+ years of experience in related field.

Bonus Points

• Experience working with Facets claims, including creating, processing, researching, and validating claim outcomes.
• Strong SQL skills, including querying, validating, and analyzing data across multiple tables.
• Experience working with complex Excel workbooks, including large data sets, formulas, and macro-enabled files, with the ability to navigate and update content accurately without disrupting workbook functionality.
• Exposure to or working knowledge of CGS+ and its role in claims processing, configuration, testing, or operational support.
• Healthcare industry experience strongly preferred

What You'll Get

• The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Learn more

Where You'll Work

Our Hybrid Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that's flexible, connected, and future focused.

In a Hybrid-Flex role, you'll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you'll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$66,998.00 - $107,197.00

Skills