Business Systems Analyst Lead w/ FACETS Claims Experience

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

The Business Systems Analyst Lead is critical to helping businesses implement technology solutions in a cost-effective way by determining the requirements of a project or program, and communicating them clearly to stakeholders, facilitators and partners, and technology team. This position leads requirements development for applying technology to satisfy business needs. Defines and documents internal and external user interfaces and supports system and data requirement clarification and definition. This individual will perform as an Integral part of the Enterprise Core Administration team, responsible for technological changes within the FACETS Claims Systems and for the exchange of data between ACFC and external Vendors.

Responsibilities:

• Analysis and documentation of current and future processes/systems and delivery of documentation for the effective implementation of stated processes.
• Critically assess impacts to the business processes as well as technical process flows and lead the introduction of new concepts and business processes.
• Demonstrate strong problem-solving capabilities and approach each problem in a logical and analytical manner with high degree of perseverance; produce definitive statement of the issues, and identification of alternative solutions, the recommended course of action, and the consequence of the decision.
• Assist in managing large scale projects, and determine project requirements and deliverables to ensure successful implementations.
• Interface with business clients, PMO, all levels of management, technical staff, architects, vendors, and others with minimal supervision to achieve project goals and initiatives.
• Understanding of file layout specifications and how to interpret them.
• Work directly with business clients, PMO, all levels of management, technical staff, architects, and vendors to analyze Business Requirements/Need and create clear & concise Functional Specifications according to standards and best practices.
• Develop and/or enhance a working knowledge of Medicaid/Medicare Healthcare Managed Care Activities: Marketing, Member Services, Health Services, Claims, Enrollment, Provider Relations, Finance, Vendor relationships and any other functional area in order to effectively communicate with all stakeholders.
• Ability to navigate relational databases, Excel files, text files or other forms of data sources to conduct data analysis activities, when needed.
• Anticipate and keep manager and project staff informed of future or planned events that could impact implementations, and/or specific problems or events that impact the project/departmental.
• Work effectively both as a member of a team and independently; establish good judgment regarding routine, significant, and sensitive matters. 
• Lead appropriate resources/initiatives, and mentor junior staff.
• Professionally lead productive meetings, deliver professional oral or written presentations.
• Actively lead and participate in requirements elicitation and apply a combination of business and technical knowledge to solve business problems with cost-effective technical solutions.  Provide guidance to the business as to what is available from technology as a solution for their need. Ability to transform business requirements to functional specifications.
• Possess complete understanding of the ecosystem surrounding requirements, upstream and downstream impacts.
• Intimate knowledge of system functionality, interfaces, screens.
• Understand the structure, policies, and operations of an organization, and recommend solutions that enable the organization to achieve its goals.
• Understand core business needs.
• Use creative problem-solving skills to remove barriers and effective communication skills to keep all parties informed regarding status.
• Performs as a strong participant within functional Agile teams.

Qualifications / Education:

• At least eight (8) to ten (10) years of relevant Healthcare Claims experience as a Business Systems Analyst in a fast-paced environment.
• HealthCare Claims experience required; experience with TriZetto FACETS with backend tables experience required.
• Adept with SQL and ability to write queries to achieve needful results.
• Experience with Blueprint, Planview, and Agility preferred.
• Ability to promote adherence to the System Development Life Cycle and Agile methodology.  
• Ability to work effectively with end-users, project teams, management, and vendors with minimal supervision.
• Ability to work as a member of a team, as well as individually, as required.
• Exceptional organizational skills and ability to manage multiple tasks with multiple priorities required.
• Demonstrates effective written and verbal communication skills required.
• Accommodate work schedule and works extra hours to meet crucial project deadlines, as required.
• B.S. or equivalent business experience.

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.