Business Systems Analyst

To apply for this and other open positions, please visit our website at www.chpw.org or use the following link:

http://tbe.taleo.net/NA8/ats/careers/jobSearch.jsp?org=CHPW&cws=1

 

COMMUNITY HEALTH PLAN OF WASHINGTON

 

Business Systems Analyst

 

 

 

KEY RELATIONSHIPS:

 

Reports To:    Director Systems Capabilities 

 

Other Key Relationships:  Internal management, staff, and external vendors.

 

FLSA:    Exempt

 

 

 

POSITION PURPOSE:

Business Systems Analyst acts as liaison between company departments and vendor configuration and development teams to assist in determining the appropriate configuration or customized application changes related to specific business areas. Defines requirements that will be used by vendor staff to configure the appropriate sub-system of the application.  Responsible for developing and maintaining acceptance test cases needed to validate the configuration and operation of the various sub-systems. Involves understanding the configuration options of the various vendor systems (e.g., QNXT) to the extent that he/she can discuss and understand the impact of the settings as well as develop user acceptance test cases which validate the overall configuration of the system. Assists departments in the development of system and workflow related employee training and help conduct training as needed.  Ensures correct business functionality and industry standards are addressed by the overall configuration of the vendor system.

 

PRINCIPLE DUTIES:

·  Assists specific business area subject matter experts in the definition of business requirements that support the configuration of the appropriate vendor system. 

·  Normally acts as primary contact between business areas and configuration staff. 

·  Develops and executes user acceptance test cases which exercise specific and overall configuration options implemented in the vendor system. 

·  Reviews test results with appropriate business area and request sign-off or documents issues and concerns for vendor.

·  Maintains and updates an inventory of acceptance test cases to include new and regression test cases that can be used to validate the accuracy of the overall system.

·  Ensures current and accurate documentation of the specific configuration setting established to support business requirements.

·  Assists departmental trainers in the development of educational tools and materials and support or provide training as needed.

·  Acts as project manager for small to medium work efforts.

·  Builds effective relationships with business units to develop a “joint” understanding of the configuration options that support the business requirements. 

·  Assists project managers regarding planning/scheduling and resource allocation.

·  Works together with consultants or project managers to ensure the business unit’s needs have been met.

·  Participates in industry and other professional networks to ensure awareness of industry standards, trends and best practices in order to strengthen organizational and technical knowledge.

·  Other duties as assigned.

 

QUALIFICATIONS: 

Education and Training: 

·  BA/BS degree in computer science or related field preferred.

·  2+ years work experience as Business Analyst, Business Systems Analyst or related. field in the healthcare insurance industry.

 

Prior Related Experience: 

·  Experience in defining and documenting requirements for computer systems that are configuration driven.

·  Experience in one or more of the following healthcare insurance industry areas :

o Eligibility, Enrollment and Member Reconciliation

o Customer Service,

o Claims Processing

o Finance to include Billing and Capitation

o Medical Management to include Case Management, Utilization Management and Disease/Population Management.

·  Experience in developing and executing user acceptance test cases. 

·  Experience in Microsoft Project 2003, Excel, Word, Visio, and PowerPoint.

 

Knowledge, Skills and Abilities:

·  Good understanding of configuration based systems to include principles, and practices related to the interaction of configuration setting across sub-systems.

·  Strong documentation skills related to requirements, test cases and general business related documentation Project management skills for small projects.

·  Ability to understand technical concepts around relational database systems.

·  Strong communication skills, both verbal and written.

·  Strong interpersonal and team skills with demonstrated ability to work well with a variety of people and circumstances at all levels of the organization and adjust to the alternate work styles of others.

·  Sensitivity to the needs of every individual to be treated with respect and fairness.

·  Ability to maintain a professional demeanor and confidentiality.

·  Ability to multi-task, prioritize, and work under pressure.

·  Excellent customer service skills.

·  Strong desire to learn and grow with changing job needs.

 

Other:

Eligible to participate in the administration of local, state and federal health care programs including Medicare and Medicaid.

 

 SENSORY/PHYSICAL/MENTAL REQUIREMENTS

 

Sensory:

·  Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

 

Physical:

·  Extended periods of sitting, computer use, talking and possibly standing.

·  Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion.

·  Frequent torso/back static position; occasional stooping, bending and twisting. 

·  Frequent finger dexterity; occasional simple grasp and wrist flexion. 

·  Occasional stooping, bending and twisting. 

·  Constant sitting, walking, or climbing stairs.

·  Some kneeling, pushing, pulling, lifting and carrying (not over 25 pounds), twisting and reaching.

 

Mental:

·  Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines.

·  Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation.

·  Ability to learn and prioritize multiple tasks at a given time and have the capability of handling demanding situations. Analytical/problem solving/critical thinking ability.

 

 

WORK ENVIRONMENT

 

Office environment with frequent environmental exposure to low-grade radiation from computer monitors; fast paced with frequent interruptions.

 

PROTECTED HEALTH INFORMATION (PHI) ACCESS

 

Community Health Plan employees will encounter protected health information in the regular course of their work at and for Community Health Plan. Community Health Plan is a Covered Entity engaging in Health Care Service Contractor treatment, payment and operations. The following scale intends to provide some indication of how often the employee may encounter or work with PHI in this particular role.  All PHI shall be used and disclosed on a Need To Know Basis and according to HIPAA Privacy Rules Part 164.  In addition, every employee shall sign a confidentiality agreement as a condition of employment and violation of that agreement and/or Community  Health Plan policies can be cause for termination. 

 

PHI is defined at 164.103 as:

"Protected health information means the individually identifiable health information that is (i) Transmitted by electronic media; (ii) Maintained in electronic media; (iii) Transmitted or maintained in any other form or medium.

Individual means the person who is the subject of protected health information.

Individually identifiable health information is information that is a subset of health information, including demographic information collected from an individual, and:
(1) Is created or received by a health care provider, health plan, employer, or health care clearinghouse; and
(2) Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and
(i) That identifies the individual; or
(ii) With respect to which there is a reasonable basis to believe the information can be used to identify the individual.

This position as described will use, encounter, read, create, disclose and or work with in general, PHI that is created by or received by Community Health Plan:

 Frequent - The position has frequent and/or daily access and responsibility for PHI.Need to know.

In all cases, PHI use and disclosure is limited to the minimum necessary amount of PHI needed to complete the treatment, payment or operations.

 

The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities or requirements of this position.

 

To apply, please visit our website at www.chpw.org