Summary:
This position is responsible for analysis, gathering and documenting requirements, testing, implementation, and process improvement activities in support of the Membership team for Government Program (Medicare & Medicaid) Products. Responsible for identifying product-related process improvements for Membership and for participating in cross-functional team meetings that include BCBSM business units and external partners This position assists with performing analysis and research, preparing reports and analyzing trends to support Membership. This position will also serve as a Membership representative on cross-functional workgroups.
Accountabilities:
1. Defines product requirements and performs business analysis. Documents the business requirements and communicates the solution through various documents including Use Cases, UI Page Specifications, Report Specification, Data requirements, Modeling diagrams and other approved documentation. Organizes and leads business requirement walkthroughs.
2. Assists in the development of project plans and schedules. Facilitates process analysis and modeling, requirements analysis and documentation, workflow, and performance (productivity and quality) measurement. Assists in the implementation and post-implementation follow-up activities including User Acceptance testing and staff training.
3. Participates in sessions on business process improvement and assists individuals and teams in documenting, standardizing and sharing improvements across the organization.
4. Identifies Membership process and system changes based on regulatory product changes. Develops training materials.
5. Serves as a resource for the Membership staff while gaining regulatory product expertise.
6. Conducts in-depth research and analysis. Identifies trends and emerging issues and recommends best practices to ensure maximum performance.
7. Assists in developing appropriate standards such as work methods, performance measurements and resources to support initiatives.
8. Documents performance measurements and process changes.
9. Creates reports, graphs and charts of data using computerized systems (PC and/or mainframe).
10. Assists in the development of organization business policies and procedures.
Required Qualifications:
1. A Bachelor'sDegree and 3 years of experience in the healthcare insuranceindustry;or 7 years of experience in the healthcare insuranceindustry in lieu of a Bachelor's Degree.
2. Experienced in the requirement gathering processes, process modeling, and the standard development life cycle.
3. Strong communication, organizataion, group facilitation and conflict resolution skills required.4. An understanding of cost benefit analyses.
4. Experience with Minnesota public health care programs and Medicare programs preferred.
