Position Overview

This position is responsible for the development and oversight of technical system requirements, report configuration, research and root cause analysis, management, communication and escalation of Application Support defects for core systems as needed. He/she will also provide analytical and data support to the operational business areas in order to maximize the department's ability to make data driven decisions and meet regulatory requirements. This role requires strong communication and analytical skills and an understanding Health Plan Operations.

• Serve as a subject matter expert to the technical functions of the core systems
• Manage the application support process for service requests, issues and enhancements
• Understand and communicate the Core product road map and manage system enhancements
• Serve as a resource in facilitating the gathering of submission data from delegated entities
• Manage a range of moderate to complex activities involving data analysis
• Perform Data and Statistical Analysis
• Contribute to development of technical requirements, functional requirements, process flows, reference materials, user guides and code release artifacts as appropriate.

Duties and Responsibilities:

Responsibilities include, but are not limited to the following:

• Acts as a liaison between department and technical groups
• Serves as a resource in facilitating the gathering of business requirements and test cases as well as coordinating and documenting
• Performs business process mapping and documentation
• Understands operational processes within the business area
• Identifies and advocates for opportunities to bring additional IT value to the business area
• Works with key project stakeholders to formulate and communicate business requirements and scope of projects
• Works with project stakeholders to translate requirements into specifications that technical staff can understand, translate questions the technical staff has into a format that stakeholders can understand
• Validates stakeholder requirements
• Writes 'use cases' as part of the requirements document
• Identifies potential areas of automation and aid in re-engineering underlying business processes
• Assists in developing and maintaining standards for development of business processes and documentation
• Other duties as assigned
• Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Required:

• Bachelors degree and/or years of experience and background to equate to the degree
• Three (3)+ years experience relating to health plan data operations, system configuration and reporting
• Three (3)+ years of related business analysis/data analysis experience
• Proficient in the use of analytical tools such as Cognos, SQL and Crystal Reports
• Strong attention to detail
• Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively at all levels of management
• Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates
• Adept in problem solving and resolving conflict
• Proficient in MS Project, Excel, PowerPoint and Word, Visio
• Ability to liaise with business users, developers, stakeholders, analysts and management.
• Strong communication skills, both verbal and written
• Must have outstanding time management and organizational skills
• Must be a self-starter and able to work with minimum supervision
• Solid organization, negotiation, and analysis skills with demonstrated ability to deliver on multiple assignments meet tight deadlines and are effective and decisive under pressure.

• IIBA Business Analysis Certification
• Extensive experience in an insurance, medical and/or HMO environment using claims processing software
• Two (2)+ years of defect management experience
• Experience in demonstrating leadership, influence and collaboration in a matrix-managed environment

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.