Business Systems Analyst Lead – Healthcare Portals Apps

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 Philadelphia, 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.

Responsibilities:

Work directly with business clients, PMO, all levels of management, technical staff, architects, and vendors to analyze Business Requirements and create clear & concise Functional and system Specifications according to standards for technical staff to use in Detailed Design and software development. Actively participate in requirements elicitation and apply a combination of business and technical knowledge to solve business problems with cost-effective technical solutions. Use creative problem solving skills to remove barriers and effective communication skills to keep all parties informed regarding status of projects. Become an SME in Provider Portal functionality for our Medicaid and Medicare business model and customer facing software applications and interactions. Mentor junior team members as needed.

• Analysis and documentation of current and future processes/systems and delivery of documentation for the effective implementation of functional solutions.
• Analyze and recommend improvements for user experience within Real Time Provider Portal and customer facing applications
• Hands-on interaction with stakeholders to support the creation of clear & concise Functional and Systems Specifications, Data Flows, and/or other deliverables according to the adopted AHC SDLC methodology.
• Coordinate and facilitate work assigned to vendors as it relates to Real-Time Provider Portal and customer facing applications.
• Prepare user stories, uses cases, acceptance criteria, screen mockups and requirements as needed
• Lead staff to develop estimates including all aspects of the end-to-end SDLC process.
• Function as the business lead to prioritize requirements through Product Backlog to ensure that business objectives are met considering delivery metrics (cost, quality and timeline).
• Familiarity with requirements management tools and Agile development methodology & tools to effectively prioritize and track the project business requirements.
• Ensure that appropriate sign-offs are received for testing approval of functionality developed for implementation.
• Ensure Business Requirements matrix is received from our PMO department to ensure that all business requirements are properly satisfied in the development and testing approval process.
• Prepare feasibility and cost analysis determinations for assigned projects
• Interface with business clients, PMO, all levels of management, technical staff, architects, vendors, and others with minimal supervision to achieve project goals and initiatives.
• Effectively communicate with all stakeholders and ability to convey technical concepts to non-technical stakeholders in a manner that enables good business decision making
• Demonstrate superior customer focus. Build consensus among stakeholders as it relates to large-scale business problems and issues.
• Assist in coordinating / facilitating large scale projects, lead appropriate resources, and identify project solutions and deliverables to ensure successful implementations to satisfy user business requirements.
• 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.
• Anticipate and keep manager and project staff informed of future or planned events that could impact implementations.
• Use sound judgment in matters where there is established or little precedent and in keeping management informed of specific problems or events that impact the departmental or overall corporate objectives
• Work effectively both as a member of a team and independently; establish good judgment regarding routine, significant, and sensitive matters or those issues for which direct response is inappropriate and promptly apprise Manager
• Professionally lead productive meetings, deliver professional oral or written presentations
• Produce and distribute monthly transactions reports for all line of business.
• Produce monthly production support matrix.

Education/Experience Required:

• Four-year degree in Management Information Systems or related field, or eight years of related work experience.
• At least five years of experience in Health Care business and functional requirements gathering.
• Experience in Agile Scrum development methodology including User Stories, Use Cases, Acceptance Criteria, Product and Sprint Backlog development.
• Experience in Agile development tools such as Jira or Version One preferred.
• Experience in managed care strongly preferred. Possess solid understanding of the Health Care industry; high level understanding of Health Care business applications; sound understanding of organizational and process development.
• IS technical applications experience strongly preferred (solid working knowledge of programming and constructs).
• UI-UX experience with Medicaid Health Care populations strongly preferred.
• Experience with MS Office products, including Visio and MS Project.
• Provider and Member Portal applications knowledge strongly preferred.
• Experience in Medicaid/Medicare Health Care systems, Claims processing experience, TriZetto Facets systems and Medical Management systems strongly preferred.
• IS Project management experience a plus.
• Experience working directly with or for a software vendor a plus.

Skills Required/Desired:

• Working knowledge of complete SDLC methodology.
• Working experience in Agile Scrum, User Stories and User Acceptance criteria is preferred.
• Provider Portal platform technology.
• Knowledge of latest mobile technologies and trends preferred.
• Demonstrated effective written and verbal communication skills required.
• Proven track record of creating concise and complete (professional grade) functional and technical solution specifications, demonstrating the facilitation of satisfying user business requirements, and coordination of the development and testing effort throughout the SDLC process.
• Ability to coordinate and facilitate completion of multiple concurrent tasks and projects required.
• Superior troubleshooting & creative problem solving skills required.
• Ability to handle multiple task assignments with changing priorities required.
• Accommodate work schedule and works extra hours to meet crucial project deadlines as required.
• Ability to work effectively with end-users, project teams, management, EDI trading partners, and vendors with minimal supervision required.
• Ability to work as a member of a team, as well as individual contributor, required.
• Working knowledge of HIPAA standards and X12 EDI transaction formats preferred.
• Keeps abreast of industry standards and development best practices.
• Supports and carries out the AmeriHealth Caritas Mission and Values.