Business Analyst Princ I

Business Analyst Princ I

Job ID 2013-23648 # Positions 1
Location US-VA-Chesapeake
Search Category Information Technology
Type Regular Full-Time (30+ hours) Posted Date 8/7/2013
Additional Locations ..

More information about this job:
Summary:

Responsible for functional area business analysis and how the functional areas interrelate, gathering requirements, performing analysis, managing the design, configuration, development and testing processes and system changes, and understanding the applications, data, and associated technologies for supported areas. Analyzes data for studies of management and operational procedures to determine cost efficiency, corrective action and compliance with goals and objectives. Analyze highly complex business problems to be solved with automated systems and other resources. Develops and maintains positive client relationships in functioning as the liaison between the business, health plans, operational areas and Information Technology Services (ITS). Work with staff to ensure requirements will be incorporated into system design and testing. Support departmental methodologies and provide input for improvement to tools and processes. Leads cross-functional linked teams to address business or systems issues. Acts as an advocate to ensure quality and timeliness of project deliverables. Provide leadership within the team, department, and organization.

Responsibilities:

1. Perform detailed requirements gathering, analysis, design, configuration, and process and data flow diagramming for processes of high complexity. Understand and consider the relationship between processes and business policies.

2. Function as a liaison between business, health plans, operational areas, and ITS.

3. Identify risks and multiple solutions.

4. Recommend and implements improvements to existing procedures. Influence others to follow existing procedures.

5. Lead all system/application testing for implementations, conversions, upgrades and updates including individual claim and batch testing. Ensure all application updates are implemented timely.

6. Develop and adhere to existing configuration management procedures. Recommend improvements to existing procedures.

7. Read and interpret design document conceptual, logical, and physical models to include context diagrams, data flow diagrams, process flow diagrams, data dictionaries and logical flow charts.

8. Develop complex queries and reports. Perform database updates.

9. Write, revise, and verify test plans for multiple complex systems in a software application. Provide leadership and guidance to other analysts in the creation of system test plans.

10. Evaluate and test complex new/modified programs, applications and/or operating systems. Monitor system functionality and performance to ensure standards are met. Document and track product defects. Coordinate problem resolution with development and/or product vendors.

11. Validate proposed contracts meet requirements taking into consideration financial arrangements and impacts as they apply to the budget as applicable in functional area of responsibility.

12. Make technical and functional business recommendations based on evolving technologies and evolving application trends to include infrastructure, software, database, and networks.

13. Address business challenges to improve efficiency and decision making, reduce redundancy, and ultimately enhance business results.

14. Manage multiple priorities and projects.

15. Lead and mentor functional area team members and other Business Analysts.

16. Manage project related budgets as applicable in functional area of responsibility.

17. Perform other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor's degree in Business Administration, Management Information Systems, Computer Science or a related discipline. Equivalent experience in a Business or Systems Analyst role is acceptable in lieu of a degree(s).

Preferred:
- Master's degree.

Years and Type of Experience Required:

Required:
- 8 years experience in systems analysis, or business analysis.

Preferred:
- Health Care industry experience.

Certifications or Licensures

Preferred:
- CBAP (Certified Business Analyst Professional)

Language Skills

Required:
- English

Depending on the business area for a specific position, competency in one or more of the following may be Required:

Technical Competencies

Required:
- Comprehensive knowledge of core IT applications and systems.
- Advanced knowledge and skills as a subject matter expert in one or more of the following managed care business areas: Member Enrollment, Provider Information Management, Claims Processing and Adjudication, Benefits Configuration, and/or Call Center.
- Understand data modeling concepts (eg, the entity-relation model) and their application: entities and tables, relations and constraints, attribute data types and column data types.
- Able to develop creative strategies and tap the creative potential of individuals and groups.
- Able to continually assess needs and implement measures to ensure customer expectations are met or exceeded.
- Able to turn problems into opportunities for change.
- Advanced proficiency with all applicable company supported software applications.
- Able to apply configuration knowledge to resolve basic to moderate business issues, identify alternatives, determine impact, and recommend optimal configuration solutions.
- Comprehensive working knowledge of managed care operational areas and managed care products in each market in which AGP operates, including current trends in the industry.
- Advanced understanding of data architecture.
- Advanced understanding of infrastructure associated with supported applications.
- Extensive knowledge of analysis techniques and standards and set analysis standards.
- Comprehensive understanding of how each department/health plan relates to the organization as a whole.

Computer Skills and Office Equipment - Advanced
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine. Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data. Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.

Spreadsheet Utilization and Management - Advanced
- Expert level of proficiency in use of spreadsheet applications such as Excel including ability to use large data sets, filters to find specific data in a large list and calculation tools. Ability to create spreadsheets in spreadsheets.

Database Utilization and Database Management - Intermediate
- Proficient in database utilization including ability to conduct queries and design databases, and perform multiple table query design. Multi table. Ability to perform general data analysis. Accounts of records of a certain type.

Systems - Expert
- Understands systems development lifecycle. Understanding of system's utilization and considered a systems SME for the following systems:
- NetworX/Facets - build pricing based on provider contracts using Facets applications. Build benefit plans based on State regulations using Facets benefit applications.
- MACESS - contracts and claim images are stored. MACESS Workflow tool for contract life-cycle.
- Software products from Ingenix for prospective payment system (PPS) - pricing.
- Clearquest is used to track projects -knowledge and familiarity using a project inventory tracking system.

Applications/Tools - Intermediate
- Ability to leverage available tools such as:
- TOAD, UltraEdit, Microsoft Project, Microsoft query analyzer SQL mgr, VISIO, (Google), Internet Search, Internet research, use and understand generally accepted templates and BA tools. Powerpoint. SDLC (software development life-cycle), TeamTrack, SharePoint, Ability to go through CNR (change notification request) process.

Industry Knowledge & Familiarity - Basic
- General healthcare, who are our providers (hospitals phy ofc, ancil) who are payors (insurance companies),
- High level claims process, knowledge of general industry how it works.
- More specific knowledge around reimbursement methodology, fee schedules. Per case, per diem, DRG, % of charges, those terms. HIPAA.
- Specific knowledge of code sets such as revenue codes, procedure codes (CPT4, HCPCS, ICD9/10), Diagnoses Related Grouping DRG codes, place of service codes (POS).

Government Programs Specific Knowledge
- Medicare Medicaid programs, CHIP and LTC.
- Eligible population, general covered services, regulatory body CMS and/or State Medicaid agency.

Gather and Document Requirements - Expert
- Mentors others.
- Viewed as a SME.
- Ability to prepare the most complex requirements documents.
- Ability to facilitate requirements gathering including determining the most efficient and effective way to capture the requirements, and managing kick off and subsequent status meetings.
- Ability to manage timelines and due dates. Ability to recognize and understand business changes that impact requirements and incorporate changes into documentation.
- Ability to read and re-read requirements documents multiple times while maintaining detail orientation.

Contracts - Intermediate
- Ability to read a contract and understand the operational requirements the contract creates. Read, review and understand a contract and tease out requirements from legal verbiage. Contracts are tedious and incumbent needs to be detail oriented and have ability to synthesize what they are reading into action, rules, requirements.

Business Analysis and Problem Solving-Analytics - Advanced
- Ability to understand moderate to complex business process flows (complex, corporate or enterprise-wide).
- Ability to thoroughly understand, analyze and synthesize data, including relationships of data, eg
- Cause/effect. Ability to conduct business analysis, requirements gathering, process analysis and gap analysis.

Project Management - Advanced
- Skilled in running multiple projects utilizing standard project management tools, techniques and methodology. Keeps projects on task.

Testing - Advanced
- Advises and mentors others. Functions independently in the creation of moderate to complex test plans, including creation of test cases/scripts, setting up data for testing, validation, analyzing test results, integration, end-to-end testing, user acceptance testing (UAT), regression testing, documentation of results and presentation of results to user.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Demonstrates understanding of the organization's mission and strategies.
- Works to clarify and understand the broader purpose and mission of own work.
- Integrates and balances big-picture concerns with day-to-day activities.
- Generates innovative ideas and solutions to problems.
- Identifies opportunities to increase efficiency, simplicity, and revenue.

Make Sound Decisions
- Approaches problems with curiosity and open-mindedness.
- Collects sufficient information to understand problems and issues.
- Analyzes problems and issues from different points of view.
- Applies accurate logic and common sense in making decisions.

People Leadership

Develop/Support Organizational Talent
- Relates to people in an open, friendly, and accepting manner.
- Treats others with respect.
- Listens carefully and attentively to others' opinions and ideas.
- Maintains positive relationships even under difficult or heated circumstances.
- Works cooperatively with people from different cultural backgrounds.

Ensure Collaboration
- Encourages people to draw on each other's strengths and experience to work together effectively, within and across teams.
- Appropriately involves others in decisions and plans that affect them.
- Provides honest, helpful feedback to others on their performance.
- Shares own experience and expertise with others.

Results Leadership

Show Drive and Initiative
- Demonstrates a "can-do" spirit, a sense of optimism, ownership, and commitment.
- Maintains a consistent, high level of productivity.
- Takes personal responsibility to make decisions and take action.
- Does not easily give up in the face of unexpected obstacles.
- Projects a positive image and serves as a role model for others.

Accountability/Optimize Execution
- Juggles many priorities and competing demands for one's time.
- Acts resourcefully to ensure that work is completed within specified time and quality parameters.
- Removes obstacles in order to move the work forward and/or get efforts back on track.
- Surfaces problems and issues before projects get derailed.

SCOPE INFORMATION

# Direct Reports:

# Indirect Reports: 0 - 15

Budgetary $ Responsibility: $0 - $3m

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to AMERIGROUP travel policies and procedures.

ermIT