(In Person- Smithfield, RI)

This position acts as a liaison between business units and the department. He/she understands the operations and technology in use by the business area, ensures that all resources are being used effectively, and actively participates in identifying current problems and future needs of the department. He/she provides basic data analysis and IT analytical support to the aligned business areas and works collaboratively with IT teams, and other departments to assist in the development of requirement documents, business cases and business plans. A successful candidate will possess leadership, communication and analytical skills.

Duties and Responsibilities:
Responsibilities include, but are not limited to the following:
Serves as a resource in facilitating the gathering of business requirements and test cases as well as coordinating and documenting for corporate projects
Performs business analysis duties for corporate projects and maintenance requests
Oversees process development and documentation for new or altered functionality or business process. Facilitate an annual audit of actual business processes
Must be able to conduct meetings and presentations to share ideas and findings
Serves as analytical resources for root cause analysis and issue resolution
Understands operational processes within the business area
Identifies and advocates for opportunities to bring additional IT value to the business area
Documents key work flows within the assigned business department
Acts as a liaison between department and technical groups
Applies industry-specific expertise to recommend and coordinate the development, enhancement, and maintenance of a departments business systems, processes and products
Combines industry expertise with a thorough understanding of information technology to develop innovative business solutions. Influences the strategic direction of the support department(s)
Performs analysis of projects of varying size
Leads requirements management and change management processes
Promotes and directs process improvement activities and training of peers and department members
Provides time/resources estimates for assigned projects
Develops innovative solutions to complex business and technology problems
Identifies full impact post-system changes and presents for claims reprocessing consideration
Day to day responsibility for complex assignments
Peer review for quality on a sampling of cases each month
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
Coordinates multiple simultaneous projects and initiatives
Other duties as assigned
Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods 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

Qualifications

Required:

• Bachelors degree and/or years of relevant work experience and background in a transferable role with relevant skill sets working in claims, system analytics, benefit management, or health plan industry to equate to the degree
• Strong interpersonal skills, with the ability to interact effectively with all levels of managerial, professional, technical and clerical staff. Ability to create strong relationships with business partners
• Intermediate to Advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook)
• Competent in use of data analysis tools such as SQL or similar tools that allow for data queries
• Must be a strategic thinker working independently with strong analytical skills, work ethic, attention to detail and the ability to perform and/or critique quantitative analyses, regulatory assessments and operational plans
• Ability to work with both internal business partners and external vendors to drive resolution for system defects and enhancements
• Demonstrate capability of utilizing IT data for business insights and analyzing business needs
• Experience in the ability to create both business requirements and end-user documentation
• Ability to analyze the design of technical systems and business models
• Strong ability to communicate and document timelines and set expectations with business customers
• Strong organizational, time management, communication (written/verbal)and prioritization skills
• Experience using and commitment to continuous quality improvement methods skills
• Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates
• Adept in problem solving and conflict resolution
• Ability to present solutions confidently to high level leadership on complex high dollar issues

• Bachelors degree
• Experienced in the use of JIRA or a similar ticketing system
• Experienced in the use of Cognos or similar tools
• Two (2)+ years of managed care/healthcare experience
• Three (3)+ years of business analysis experience
• Experience in Visio and Microsoft Access

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.