Business Analyst III – Claims Recovery - Program Integrity – PS37096

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it is a powerful combination, and the foundation upon which we are creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Business Analyst III – Claims Recovery - Program Integrity – PS37096

Location: Within the U.S. (Remote)Description:

This is an exceptional opportunity to do innovative work that means more to you and those we serve. This opportunity is within the Cost Containment Division (also known as Claims Recovery) within the Program Integrity Business Unit. We ensure the financial systems integrity is accurate and processes are streamlined. This division focuses on overpayment recoveries and claims cost corrections. This ensures the best health care practices in the industry.

The Business Analyst III translates complex business needs into application software requirements. The BA III should also be responsible for writing business process specifications including Visio Diagrams, and process instructions. We are looking for motivated, creative, solutions experts who can help take health care to the next level. BA III is responsible for serving as the liaison between the business and IT in translating complex business needs into application software. This can include supporting training, and auditing processes.

Responsibilities:

· Develops project plans and identifies and coordinates resources, involving those outside the unit.

· The ability to develop or modify complex business requirements to satisfy business needs in operationally efficient manner.

· Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, trouble shooting and documentation of business applications/systems.

· Collaborate with business owners to analyze current operational procedures, trends and identify problems.

· May provide direction and guidance to team members and serve as an expert for the team.

· Experience maintaining business and system requirements of multi-functional complex system

· Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the department's goals.

· Query development and data analysis skills strongly desired (using any database technology)

· The ability to initiate or assist with testing of changes as it relates to projects assigned.

· Act as a business liaison between system IT and Claims Recovery Department

· Strong skills in building and maintaining successful relationships with key leaders across the department and organization to insure that projects are properly supported and successfully delivered.

· May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies. Provides guidance and training to staff on process, procedures and issue resolution.

· Understanding of claims overpayment recovery processes a plus

· Ability to convert contract language into business requirements

· Provides oversight and resolves complex issues, resolving problems, and providing timely follow-up on identified issues.

· Ability to participate on project teams and add significant and measurable technical input to the projects

· Provide regular feedback to management on project status

· Performs other duties as assigned.

Requirements:

· Requires a BS/BA degree; or any combination of education and experienced, which would provide an equivalent background.

· 5-7 years of business analysis experience that includes knowledge of systems capabilities and business operations including ability to understand detailed business processes and enabling software.

· The ability to identify any process, technology, or organizational role changes that would pose risks on any assigned projects or initiatives relative to the department and offer mitigation and contingency plans.

· Strong analytical skills, high attention to detail, and proven ability to be an innovative problem solver.

· Organize and present ideas in a convincing and compelling manner.

· Persuade and influence others with effective verbal and written communication.

· Strong communication skills both written and verbal to represent the department in various meetings with various levels of management.

· Strong organizational skills to be able to manage supporting multiple projects at one time.

· Experience in the following is a plus: IBM Doors, HP Unified Functional Testing, IBM Blueworks, Six Sigma, CMMI, ITIL, Process ModelingAnthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc. magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at Careers.antheminc.comAn Equal Opportunity Employer/Disability/VeteranREQNUMBER: PS37096