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Business Process Analyst - Risk Adjustment

Business Process Analyst - Risk Adjustment

Wyoming StaffingCheyenne, WY, US
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Job Opportunity At Highmark Inc.

Job Summary : This role provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. May troubleshoot errors, conduct impact analyses, and / or solve data rejection. Performs business analyses in one or more operational areas. Identifies process gaps and recommends process improvements for efficiencies. May provide guidance to Associate level employees. This role sits within our Risk Adjustment team - it is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.

Essential Responsibilities :

  • Intake operational objectives and gather information. May perform routine research and evaluate basic output requirements and formats. Communicate business operational requirements to internal groups responsible for developing / testing business requirements in various applications.
  • Coordinate, monitor, and report on the progress of projects to ensure adherence to defined project schedule. Communicate effectively with customers and colleagues. Successfully articulate issues, problems, and solutions. Conduct pre-and post-implementation review. Assist in the planning / designing and facilitation of functional walk-throughs. May require additional support from more experienced team members.
  • Manage small to intermediate cross-functional projects and change initiatives involved in the design and delivery of business process solutions, implementation strategies, and control measures, including scoping, leading, and influencing organizational change related to business processes and models.
  • Facilitate process improvement meetings and / or discussions. Analyze the functions and operations of a business area / function and identify problem areas. Create process mapping and document current and future state business processes.
  • Recommend process efficiencies, strategies for improvement, and / or solutions to align technology with business strategies. Assist in development of desktop procedures and / or training material. Other duties as assigned.

Education :

  • Required : High School Diploma / GED
  • Substitutions : None
  • Preferred : Bachelor's Degree
  • Experience :

  • Required : 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, customer service, etc.)
  • Preferred : 1 - 3 years in the Health Insurance Industry
  • Licenses or Certifications :

  • Required : None
  • Preferred : None
  • Skills :

  • Analysis of business problems / needs
  • Written & Oral Presentation Skills
  • Business Analysis
  • Business Process Design
  • Business Process Improvement
  • Business Process Mapping
  • Business Requirements
  • Collaborative Problem Solving
  • Project Management
  • Languages (other than English) : None

    Travel Required : 0% - 25%

    Physical, Mental Demands and Working Conditions :

  • Position Type : Office-Based Teaches / trains others regularly
  • Occasionally Travel : regularly from the office to various work sites or from site-to-site
  • Rarely Works : primarily out-of-the office selling products / services (sales employees)
  • Never Physical work site required : Yes
  • Lifting : up to 10 pounds Constantly Lifting : 10 to 25 pounds
  • Disclaimer : The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

    Compliance Requirement : This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

    Pay Range : Minimum : $50,200.00 Maximum : $91,200.00

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    Analyst Risk Adjustment • Cheyenne, WY, US

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