Posted in Other 27 days ago.
Type: Full Time
Provides solution design, data analysis support, testing and hands-on configuration of the Trizetto Healthcare Products applications This includes effectively implementing new application capabilities and subsequently assuming on-going operational responsibility for enhancing and maintenance of the applications. Works with business process leaders to translate new business requirements and processes into package requirements and subsequent effective configuration. Applies professional principals and techniques to standard work assignments but seeks guidance on more complex work.
* Analyze medium to hard customers' business requirements and software/product objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures.
* Development of prototype configuration to support solution selection and develop documented solutions and processes using appropriate documentation protocols.
* Resolve escalated issues in the appropriate manner and appropriate timeframe, to meet client specific SLAs.
* Identifying gaps between external expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques.
* Estimate time frames, quality and quantity of resources required to successfully complete activities.
* Provide periodic status checks on all project activities to clients and internal teams, to assess progress against project plan.
* Providing regular and concise status reports to clients and direct manager.
* Ensure traceability of configuration solutions back to performance goals and metrics.
* Act as the liaison between IT and business areas in support of extensions and service packs.
* Other duties as assigned
* 2+ years performing complex business &/or technology operations including experience with healthcare claims across all Lines of Business
* Hands on configuration/implementation knowledge of core benefit administration package software (e.g., Facets) or hands on subject matter expertise in Blue Plan operational processes.
* Strong understanding of claims processing, core Facets functionality and ITS Home/Host processing across all lines of business (Commercial, Medicare, Medi-Cal) is a plus.
* Strong analytical skills required
* Strong written and verbal communication skills
* Demonstrated advanced competence with MS Word and Excel.
* Strong understanding of database concepts and competence with MS Access/SQL Developer are preferred
* Bachelors degree or equivalent number of years of relevant experience performing complex business analysis &/or technology healthcare operations
- Our Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!
- Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
- Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
- Requisition ID: 20002DW
- Posting Date: Oct 28, 2020
- Schedule: Full-time