A new Job, ID: 38576 <http://www.ejobsville.com/display-job/38576> was
added at eJobsVille.com - For the Best Tech Jobs in
Town<http://www.ejobsville.com>
Title: Sr. Business Analyst with TriZetto Facets Experience posted on
2013-09-20 12:53:33
Job Description:*Job Summary*
The Senior Business Analyst acts as the primary liaison between IT and the
operational departments **(See openings)* within the organization. This
position functions in a trusted advisor role, by providing subject matter
expertise to the clients in which it serves, through analysis activities
and the development of business and functional requirements for initiatives
of all sizes. The Senior Business Analyst serves in a customer
relationship management role to increase customer service, and participates
on project teams to assist in a timely delivery of all IT projects. This
role also serves as a mentor to team members.
* *
**Openings*
*Customer Billing and Receivables* – Additional qualifications
include:
o Previous experience with health care customer invoicing systems, which
includes the generation of customer invoices, payment receipt processing
methodologies (EFT, credit card), reconciliation, refunds, write-offs, and
delinquency
o Experience with customer invoicing systems from other industries will
be considered
o Knowledge of customer, product and pricing concepts required
o Knowledge of Medicare and Medicaid processing a plus
o Billing entities include individual consumers, NY State, the Federal
government, and other ancillary parties
o Ability to query and map data
o TriZetto Facets Billing and Accounting experience is preferred
including batch processing
o Knowledge of EDI 835, 837 and 820 characters is a plus
o Preferred location of work is in Queens, NY office.
*Enrollment Processing* – Additional qualifications include:
o Previous experience with customer enrollment processing, which
includes the acceptance and processing of enrollment applications (paper
and electronic) from various external sources including Medicare (CMS),
Medicaid, Maximus, Dept of Social Services, Brokers, Individual Consumers
as well as employers.
o Experience with group, customer, and product concepts
o Experience with enrollment rule requirements and differences by
product line
o Ability to work with file processing as well as query and map data
o TriZetto Facets Group, Subgroup, Class/Plan, Product and
Subscriber/Family application experience is preferred
o Knowledge of EDI 834 and NYS Roster and KIDS system formats a plus
o Knowledge of customer outputs that are by-products of enrollment such
as contracts and ID Cards.
*Member/Provider Services* – Additional qualifications include:
o Previous experience with the provider and customer service functions,
which includes applications and processes used to service and support
interactions with consumers/providers including: Customer service
tracking software, CTI/screen pops, Phone applications, IVR, Call-volume
and other ancillary reporting, as well as other tools and resources needed
to effectively service these constituents
o Experience with group, customer, and product and customer service
applications
o Experience with servicing of health care providers
o Knowledge of Appeals & Grievance processes
o Ability to work with broad type of technologies as noted above
o Ability to query and map data and define file specifications for
third-party vendor relationships
o TriZetto Facets Group, Subgroup, Class/Plan, Product and
Subscriber/Family application experience is preferred in addition to
Provider, Customer Service and Appeals & Grievances
o Knowledge of claims as well as customer outputs that are by-products
of enrollment such as contracts and ID Cards a plus
*Medicare Services* – Additional qualifications include:
o Knowledgable on Medicare
Job Requirements: *Responsibilities*
- Analyzing business domain and development of workflows and
requirements for proposed solutions in support of day-to-day and project
initiatives
- Subject matter expertize and ownership of assigned operational area
- Defining problem/need and primary objectives for new projects,
identifying and validating key requirements.
- Leading of requirements elicitation sessions
- Conducting requirements reviews to obtain sign-off from
project/operational stakeholders.
- Documenting and appropriately capturing functional specifications used
for software design and development.
- Preparation and maintenance of project-related requirements artifacts
– Business & Functional Requirements Document, Software Requirements
Traceability Matrix, Use Case Diagrams, etc.
- Managing project tasks assigned within scope, quality and timeframe
allocated with PM/departmental supervision.
- Identifying and recording of risks, issues, dependencies and
assumptions in accordance with project standards.
- Interaction with all areas of Information Technology as well as
software vendors
- End-to-end ownership of assigned initiatives – requirements through
implementation
- Problem analysis in batch and online environments with the ability to
interrogate error codes
- Analyzing and querying data, knowledge of the Facets data model
- Testing, including the creation of test scenarios, test data and
knowledge of outcomes
- Interaction and engagement with leadership and staff from assigned and
supporting operational area
- Mentoring of clients and peers
*Qualifications*
- BA/BS - Bachelors Degree or equivalent required. Degree in Computer
Science or Computer Programming a plus.
- Minimum 5-8 years previous experience as a Business/Systems Analyst
- Health Care Industry experience - understanding of Medicaid and
Medicare programs a plus.
- Proficiency with Microsoft tools including Excel, Word, Visio,
PowerPoint, and Access
- Proficiency with SQL (querying, analyzing and mapping data)
- Demonstrated ability to lead and elicit business needs and
requirements from a diverse set of stakeholders and successfully document
and communicate requirements to the stakeholders, developers and testers.
- Demonstrated ability to construct or modify use case diagrams and
process models.
- Demonstrated ability to create test scenarios
- Experienced in full software development life cycle
- Understanding of the concept of online and batch environments
- Ability to work multiple, time-critical tasks.
- Demonstrated ability to analyze and solve problems
- Excellent oral and written communications skills with the ability to
interact with all levels of leadership
- Excellent interpersonal skills
- Demonstrated knowledge of TriZetto Facets online environment, batch
environment and data model experience preferred
Click here to view full job description and
apply<http://www.ejobsville.com/display-job/38576>
(Guest users can also apply)
------------------------------
Best regards,
eJobsVille.com - For The Best Tech Jobs In Town
--
You received this message because you are subscribed to the Google Groups "SAP
ABAP" group.
To unsubscribe from this group and stop receiving emails from it, send an email
to sap-abap+unsubscr...@googlegroups.com.
To post to this group, send email to sap-abap@googlegroups.com.
Visit this group at http://groups.google.com/group/sap-abap.
For more options, visit https://groups.google.com/groups/opt_out.
