Pay Range:
$93,600.00 - $140,400.00
Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
Why this job matters:
Analyze complex technical issues and identify projects and technologies which will produce significant operational results and add value to the corporation. Conduct business requirements reviews and independently formulate logical statements of business requirements. Formulate and define technical scope to align with business objectives based on both user needs and technology strategy. Develop technical system specifications, resources and processes for a complex sub-systems or major systems modification.
What you will do:
- Participate in business requirements sessions to define technical requirements. Gather technical requirements, ask probing questions, document findings, and incorporate feedback. Translate business needs into technical requirements. Formulate and define technical scope to align with business objectives based on both user needs and technology strategy.
- Analyze and revise existing system logic difficulties.
- Partner with business process experts to learn and understand problems or required changes with software. Develop detailed selection evaluation criteria based on identified IT product requirements.
- Assume leadership role in defining technical requirements and solutions.
- Create and/or assist in the creation of technical documentation that describe how systems should be created/modified to meet business requests. Review and approve the designs of vendors who create these types of documents.
- Map business data elements to backend data sources.
- Mentor technical analysts in methodology for defining and documenting technical requirements and defining technology roadmap.
- Participate in functional specification and design reviews, validating technical aspects. Offer expert advice to technical staff.
- Provide innovation to business areas and contribute to improve operational processes by advising in technical expertise.
- Review and sign off on vendor delivered technical specifications.
- Mentor less experienced staff.
- Lead department projects and initiatives.
- Perform other duties as assigned.
What you need to succeed:
- A combination of education and related work experience
- Experience creating technical documents
- Knowledge of implementation and conversion activities
- API and batch system expertise
- Knowledge of modern web-based application design and client server technology
- Strategic and critical thinking skills
- Strong analytical skills
- Strong business acumen and political savvy
- Strong negotiation skills
- Strong written and verbal communication skills
- Strong problem-solving skills
- Ability to work effectively with a wide variety of people in individual and group settings.
- Strong organizing skills, with the ability to prioritize and respond to shifting deadlines.
- Strong time management skills
- Ability to manage diverse and deadline-oriented workflow.
The extras:
- Bachelor’s degree in Computer Science, Information Systems, Business, or Engineering; or an equivalent combination of education and applicable work experience
- Five to seven years of systems analysis experience, working on key business processes to define technical requirements.
- Experience with Facets or other healthcare payor adjudication systems.·
- Experience with NetworX Pricer or other healthcare claims pricing engine.
- Experience with provider agreements, facility claim adjudication, service and procedure code setup.
- Experience with groupers and editors such as 3M or Optum.
- Healthcare or insurance experience.
- Experience with Cloud based platform integrations: Azure, Google and Salesforce.
- Experience with waterfall and agile software development methodologies
Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
