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CareFirst BlueCross BlueShield · 1 day ago

Senior Business Process Analyst (Remote)

United States

Full-time

Remote

Senior Level

$66K/yr - $131K/yr

5+ years exp

CareFirst BlueCross BlueShield is seeking a Senior Business Process Analyst to support the modernization and redesign of their utilization management department. The role involves analyzing business processes, coordinating with technical teams, and managing process improvements to enhance operational efficiencies.

Health CareNon ProfitService Industry

No H1B

Responsibilities

Analyzes business processes and coordinates with technical (IT) teams to analyze technical and clinical processes and resolve problems. This includes coordination and input to formulate and develop new and modified business platforms and workflows that results in automation and driving efficiencies for the UM teams

Interfaces with all areas affected by the project including clinical and non-clinical end users, computer services, and other key stakeholders

Represents the UM department to define requirements and business cases for the technology developments

Identify current processes and potential changes to ensure increased operational efficiencies and productivity improvements for the UM staff and related internal clinical partners

Conduct process analysis activities to include interviewing, observing, and timing of operational tasks for current state and future state. Map individual task workflow; create and maintain workflow charts for all major tasks; update and validate models, service agreements and cost benefit documentation

Qualification

Business Process AnalysisUtilization ManagementTechnical KnowledgeMicrosoft OfficeChange ManagementCommunication SkillsCollaboration SkillsSelf-Starter

Required

Bachelor's Degree in Business Administration, Business Management or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience

5 years operational analysis experience or 2 years as a Business Process Analyst

Skill in analyzing and organizing technical data

Proficient in Microsoft Office programs

Excellent communication skills both written and verbal

Self starter and ability to collaborate with associates of various levels

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence

Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging

Must be eligible to work in the U.S. without Sponsorship

Preferred

Certified in Business Analysis -PMI

Deep understanding of utilization management to drive efficiencies and best practice for UM teams

Working knowledge of CareFirst structure and business areas to support the change process from beginning to end

Understanding of plan design across all commercial and government programs plans and experience administering plans in a large payer organization is helpful

Overall technical knowledge and understanding of Guiding Care, Facets, and other key systems as well as how to navigate through compliance requirements is helpful

Ability to work across multiple business areas, collaborate with peers, clinical, clinical support, medical director, and other levels while ensuring alignment with department and organizational goals is crucial to be successful

Must be able to work efficiently and independently and as part of a team to support critical initiatives in alignment with direction established through thought partnership with the Director of UM and the VP/CMO of Medical Management

Ability to use proper change management principles is important as this role will be involved in changes made to the clinical and clinical support operations and processes