Payment Integrity Systems Analyst Open to hiring at Sr level

Define review and scrutinize all business requirements for system solutions; new and existing system capabilities. Plan develop and test all phases of business system solutions. Coordinate and facilitate strong internal partnerships with Technology and vendor personnel to ensure timing of all technical deliverables/projects (e.g. modifications interfaces upgrades conversions etc.. Work directly with internal and external stakeholders on all projects related to payment integrity. Support and cultivate department process improvement activities.

Qualifications :

Required:

• Associate degree or direct and applicable work experience.
• Minimum 4 years of related experience in a business analyst systems analyst or related role.
• Experience combining technical acumen with knowledge of operational business processes demonstrated through documentation or translation of business requirements system testing business process improvement etc.
• Facets system knowledge and/or experience as well as experience combining technical expertise with knowledge of operational business processes demonstrated through elicitation translation or documentation of business requirements system testing etc.
• Demonstrated familiarity with APRDRGs and/or EAPG groupers claims pricing/ payments etc.
• Strong communications skills (verbal/written) with the ability to articulate complex information or solutions to internal and external stakeholders including vendors.
• Demonstrated critical thinking problem solving/troubleshooting and continuous process improvement skills.
• Workflow management skills including an understanding of sequential progression of tasks or processes and their respective impacts.
• Selfstarter with strong time management organization skills and the ability to effectively prioritize projects or tasks.

Preferred:

• Advanced level of proficiency with MS Excel.
• Experience consulting with stakeholders
• Exposure to negotiation skills and techniques
• Experience using agile requirements management tools like Azure DevOps
• Experience partnering with global staffing vendors to deliver projects
• Bachelors Degree

Additional Information :

a. Define review and scrutinize all business requirements for payment integrity related system solutions; monitors and maintains the integrity of the system infrastructure and acts as the subject matter expert (SME) for business and technical requirements.

b.  Interact and partner with project/program managers to ensure active participation; clarify understanding of high level business needs and requirements on complex projects.

c. Test all phases of payment integrity related business system solutions. Coordinate and facilitate strong internal partnerships with internal and external stakeholders to ensure timing of all technical deliverables/projects (e.g. modifications interfaces upgrades conversions etc..

d. Keep informed support and adhere to regulations Wellmarks software development lifecycle (SDLC) operational procedures and other business analysis protocols. Ensure that system conversion and release upgrades are implemented timely with associated business documentation and training prior to the implementation. 

e. Work with company resources to accomplish changes to programs and systems. Ensure that processing system infrastructures are kept stable and in compliance with regulating bodies and entities. Assist other business staff in determining best practices for business process improvement.

f. Other duties as assigned.

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