Business Analyst III

Horizon Blue Cross Blue Shield of New Jersey is hiring a Business Analyst III to research customer issues and identify root causes of operational deficiencies. The role interprets regulatory mandates, develops business and technical requirements, analyzes data, supports projects and testing, and helps improve cross-functional operational performance.

Responsibilities:

• Analyze regulatory materials, guidance, communications, and correspondence to understand assigned mandate and EOB requirements
• Serve as the subject matter expert for assigned mandates and partner with Legal, Compliance, Privacy, Operations, IT, and business teams to interpret requirements
• Partner with the assigned Business Systems Analyst (BSA) to develop the Initiative Request Form (IRF) and project scope summary, ensuring mandate requirements, compliance considerations, and impacted business areas are accurately represented to support development of the High-Level Business Case (HLBC)
• Ensure Compliance is engaged at the appropriate level (stakeholder, approver, etc.)
• Translate business requirements and assist IT with the development of technical specifications
• Develop solutions based on data analysis to increase business efficiency
• Lead or participate in internal and external project workgroup(s) and presentations
• Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc
• Prepare materials for internal and external audit activities; review audit findings/reports for accuracy and completeness. If appropriate, formulate rebuttal and/or corrective action steps
• May coach/mentor less experienced staff, assist in on-boarding of new staff and/or distribute and follow-up on work assignments
• Perform other relevant tasks as assigned by management

Requirements:

• High School Diploma/GED required
• Minimum of seven (7) years' experience in an operational role, or analytical role
• Knowledge of Healthcare industry required
• Knowledge of Project Management methodologies
• Bachelor degree preferred or relevant experience in lieu of degree