Business Systems Analyst III - Claims

Fidelis Care   •  

Rochester, NY

Industry: Healthcare


Less than 5 years

Posted 122 days ago

This job is no longer available.

Essential Functions and Responsibilities


  • Establish and build relationship with assigned business/operational stakeholders. Understand business processes, map them to systems capabilities, then recommend technical solutions, applying strong understanding of applicable business systems and industry requirements.
  • Strengthen subject matter expertise in the IT applications and data models critical to the operation. Investigate, document and communicate system application functionality to peers and operational users.
  • Develop understanding of business strategy, priorities, organizational structure and key performance indicators (KPIs). Identify, define, and scope initiatives that can be enabled by IT services.
  • Collaborate with IT and operational stakeholders to identify and communicate request and project priorities.
  • Work collaboratively with the Project Delivery Office and/or Development teams to provide project effort and cost estimates; Act as functional and/or IT lead on medium and project sized initiatives.
  • Work collaboratively with the IT Architecture team to ensure proposed solutions are in compliance with the recommended technology portfolio. Work collaboratively with peers and project teams to ensure proposed solution meets the needs of the customer and business/operational stakeholders.
  • Collect, analyze, and summarize data using SQL and other data mining tools to deliver information to customers, assist with recommendations. Translate business requirements to IT functional or technical requirements working collaboratively with IT development teams.
  • Document existing and new business processes and workflows with a high level of complexity. Create source to target data mapping documents inclusive of business rules. Perform system configuration to ensure business requirements are fulfilled.
  • Create, coordinate and execute QA and UAT test plans with internal test teams and business partners for successful end to end results. Lead RFP initiatives.  Implement and support packaged and custom developed software solutions.  Orchestrate business value realization post-implementation.
  • Author user and system documentation; assist with operational user training. Adhere to Fidelis Care standards on the creation and peer review of functional requirements.
  • Develop IT application and technical skills through ongoing formal and informal/self-training. Job performance requires fulfilling other incidental or related duties as assigned and performing duties of higher rated positions from time to time for development purposes.

Educational and Experience Requirements

Work Related Experience:

  • Three to five years’ experience as a Business Systems Analyst III or equivalent (including technical/requirements development)
  • Five to seven years of related IT work experience strongly preferred in the health insurance industry, with broad exposure to various technical environments and business segments.
  • Requires thorough knowledge of system development life cycle and implementation methodologies. Requires advanced working knowledge in structured query languages and data analysis techniques.
  • Demonstrates ability to apply structure to a loosely defined problem. Demonstrates advanced understanding of core business functions.
  • Experience with analyzing and leading the integration of processing sub-systems. Experience with relational databases (Oracle, MySQL, SQL Server). Strong knowledge of SQL query syntax and methodology.
  • Working knowledge and/or understudy of programming languages. Strong understanding of software development and/or package software implementation.
  • Requires understanding complex and detailed business processes and identify opportunities and risks; able to define the problem, ask the right questions and find the right inputs for resolutions.
  • Collaboration and Teaming: drive collaboration among divergent groups (IT functions, business groups, GPOs, etc.) to accomplish defined objectives.
  • Strong understanding of project management techniques/methodologies. Advanced understanding of business and business systems analysis.
  • Problem solving skills. Prior experience with creating test documents and script testing.
  • Competent use of Microsoft Office applications to include Microsoft Project, Excel, Visio, PowerPoint, Word.
  • Strong communication and presentation skills with ability to communicate with all levels of the organization.  Writing sample must be provided as part of the interview process. Must be able to understand complex and detailed business processes and identify opportunities and risks; able to define the problem, ask the right questions and find the right inputs for resolutions.

Education, License, and Certification Requirements

  • Bachelor’s Degree in Computer Science, Information Systems, Business Administration, or other related field required (equivalent work experience may be considered).