Blue Cross Blue Shield of North Carolina

Principal Facets Application System Analyst

US-Anywhere
+ 27 other locationsRemote
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or advanced degree (where required)
  • 8+ years of experience in related field
  • In lieu of degree, 10+ years of experience in related field
  • Trizetto Facets enrollment, billing and/or claims required
  • Strong knowledge with payer systems and enrollment functions.

Responsibilities

  • Facilitate design, construction, deployment, and maintenance of complex technical solutions.
  • Elaborate business requirements into functional designs that are enterprise-oriented.
  • Conduct systems analysis to validate designs and perform reverse engineering of code as needed.
  • Prioritize requirements through negotiation and systems analysis techniques.
  • Create functional designs ensuring end-to-end traceability and manage system impact of changes.
  • Serve as a trusted advisor or Subject Matter Expert for systems analysis and process design services.
  • Provide consultancy to business partners on technology applicability to address requirements.

Benefits

  • Opportunity to work at the cutting edge of health care delivery.
  • Work-life balance, flexibility, and autonomy in work.
  • Medical, dental, and vision coverage with health and wellness programs.
  • Parental leave and support, along with adoption and surrogacy assistance.
  • Career development programs and tuition reimbursement for education.
Full Job Description

Job Description

Responsible for the end to end completion of requirements elaboration and system functional design to solution the most complex enterprise-wide business demands through enabling technology and/or business processes that impact multiple business units, lines of business, processes, and/or multi-project portfolio. Discern true business needs, facilitate work sessions; document, elaborate and prioritize requirements and specifications; and manage scope as input to functional, architectural and technical design. Ensure the quality, cost effectiveness, and timeliness of key business services and regulatory requirements or mandates via integrated enterprise solutions. Work directly with both business clients and cross domain technology partners to translate relevant enterprise business requirements into technical solutions via functional design.

WhatYoullDo 

  • Facilitate and influence the design, construction, deployment, and ongoing maintenance of specific complex technical solutions through design documents, gap analysis, business rule and data mapping management, risk assessment, traceability mapping and financial and timeline constraints to balance ROI.

  • Elaborate business requirements, rules, and data elements into functional designs that are both complex in nature and enterprise oriented. Applicable business requirements and processes are reviewed, analyzed, and translated into system function points.

  • Conduct systems analysis to validate designs. Perform or facilitate reverse engineering of code when required. Create functional designs that meet systems analysis standards and are aligned with the Enterprise Business Process Architecture.

  • Prioritize requirements through negotiation, release and phase management techniques and systems analysis techniques and tools.

  • Create and document functional designs of business solutions. Ensure end-to-end traceability through appropriate artifacts. Determine and manage enterprise wide, upstream and downstream system impacts of proposed changes and enhancements.

  • Maintain and utilize detailed system, application, and component analysis and design knowledge related to the construction of broad based and highly complex solutions, which requires detailed knowledge of the processes, technologies, and people components.

  • Serve as a trusted, expert advisor or a Subject Matter Expert for systems analysis and process design services.

  • Provide consultancy and advice to business partners on the applicability and usability of alternative technology to help address business requirements, problems or issues.

  • Review documents and models produced by Business Analysts, Architects, and Developers to ensure end to end quality of the product.

  • Support program and portfolio management goals through assessment of business solutions for decomposition of projects into multiple production releases to meet business owner needs. Recognize and manage technical synergies and conflicts across concurrent project activity.

  • Participate in the development and support of scope and implementation strategies, including definition, development, and planning of incremental or iterative phasing for design, construction and implementation.

  • Interpret and translate impacts, risks, and gaps across technical and non-technical audiences to ensure a holistic understanding of business and user requirements.

  • Coordinate work of teams to effectively define, analyze, and develop enterprise solutions.

  • Lead and mentor less experienced staff to influence the maturation of the practice.

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • 8+ years of experience in related field.

  • In lieu of degree, 10+ years of experience in related field.

  • Trizetto Facets enrollment , billing and /or claims required.

  • Strong knowledge with payer systems and enrollment functions, processing and automation.

Bonus Points

  • Proven experience migrating enrollment platforms and supporting end-to-end deployment activities.

  • EDI 834 experience preferred but not required.

WhatYoullGet

  • The opportunity to work at thecutting edgeof health care delivery with a teamthatsdeeply invested in the community

  • Work-life balance, flexibility, and the autonomy to dogreat work

  • Medical, dental, and vision coverage along withnumeroushealth and wellness programs

  • Parental leave and support plus adoption and surrogacyassistance

  • Career development programs and tuition reimbursement for continued education

  • 401k match including an annual company contribution

  • Learn more

Where Youll 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 thats flexible, connected, and future focused.

In a Hybrid-Flex role, youll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, youll 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.

$118,691.00 - $189,906.00

Skills

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About Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield of North Carolina (BCBSNC) is a non-profit health insurance company based in Durham, North Carolina. The company provides health insurance to more than 3.7 million customers in North Carolina. BCBSNC offers a variety of health insurance plans, including individual and family plans, Medicare Advantage plans, and employer-sponsored plans. The company also offers wellness programs and resources to help customers manage their health. BCBSNC was founded in 1933 and has since grown to become one of the largest health insurance providers in North Carolina.
Learn more about Blue Cross Blue Shield of North Carolina
Size
5,000 employees
Industry

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