Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

On behalf of internal and external customers, gather and document business requirements, provide research and analysis related to project deliverables or production (break/fix) issues, conduct all necessary testing prior to delivery, and act as a liaison between business customers, external customers, project teams and other Agile teams. You will have a unique blend of technical expertise and healthcare claims knowledge (...think Claims Processing and EDI transaction data 837, 270 & 271).

REQUIRED QUALIFICATIONS

Required Work Experience (All levels)

2 years of experience in healthcare or insurance field with an emphasis on business processes or system analytics.
2 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business
Or, 1-year experience in end-to-end business processes with increased exposure to system configuration and integrations

Required Education

High-School Diploma or GED in general field of study (All Levels)

Required Licenses

Required Certifications

PREFERRED QUALIFICATIONS

Preferred Work Experience (All levels)

5 years of experience in healthcare or insurance field with an emphasis on business processes and system analytics including EDI and integrations.
5 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside the business
1 year of experience in project management

Preferred Education

Bachelor’s Degree in Computer Science, Information Systems, Business, or related field (All levels)

Preferred Licenses

Preferred Certifications

Business Analyst Certification (All levels)
Six Sigma Certification (All levels)
Software Testing Certifications (All levels)

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

Level 1

Write and review business requirements, flow specifications or change requests
Write test scripts, perform testing and post-production validation
Conduct research and analysis for issue resolution relating to electronic transactions, medical management or clinical management systems, customer service applications, claim adjudication systems including reporting, process efficiencies. Track all items through to resolution.
Provide first or second level support for internal/external customers
Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
Act as a liaison between external, all segment customers and all IT; communicate system and process changes to business areas

Level 2

Develop moderate complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with limited management direction.

Provide subject matter expert (SME) advice related to electronic transactions and other corporate systems in the prioritization of workload or issue research.
Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities.
Lead small to medium size projects.
Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency, and completeness
Resolve differences between customers and other team members to achieve organizational and project goals
Utilize existing reporting tools to develop and execute data queries for ad hoc requests; understand data source structures
Understand EDI formats/syntax and file transfer protocols
Support multiple segments of business
Mentors Level 1 Analysts

Level 3

Develop complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with little to no management direction.
Decompose high-level project information and evaluate project components to forecast work effort required
Act as lead analyst for large or complex projects
Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business.
Fully support all business segments
Mentors Level 1 and 2 Analysts

Level 4

Ensures Service Level Agreements between department and operational or technical areas are met
Act as lead analyst for large or complex projects with minimal guidance from lead or manager
Mentors all level of analysts
Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals

LEAD

Serves as the primary operational contact for internal and external customers when needed or in the absence of the Manager
Participates in evaluation and writing of performance reviews for level 1 and possibly level 2 analysts
Develop and mentors’ staff by providing opportunities for growth through delegation, training, and assignment to various project teams
Informs the manager of any issues impacting the efficient and effective performance of the department including system, resource and informational barriers.
Assist the manager in the day-to-day operations of the department

ALL LEVELS

Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Participate in on-call rotation
Perform all other duties as assigned

REQUIRED COMPETENCIES

Required Job Skills (Applies to All Levels)

Strong analytical skills to support independent and effective decisions based on customer input and research
Strong problem-solving skills
Strong time management skills
Basic skills with core MS products: Word, Excel, Edge, Outlook, Visio, PowerPoint, Teams
Basic skills with query tools
Strong understanding of file handling and data translation
Excellent verbal and written communication skills and the ability to interact professionally and maintain positive working relationships with a diverse group

Required Professional Competencies (Applies to All Levels)

Prioritize tasks and work multiple priorities, sometimes under strict time constraints
Ability to build synergy with a diverse team in an ever-changing environment
Ability to exercise independent judgment and demonstrate creative problem solving techniques
Anticipates downstream impacts and factors in those considerations appropriately
Perseverance in the face of resistance or setbacks

Required Leadership Experience and Competencies

Support priorities and direction of corporate leadership
Ability to apply sound management decision making skills to perform effectively in the absence of management
Effectively deal with conflict
Ability to present concepts effectively to varying levels of staff (Applies to Levels 2 - 4)

PREFERRED COMPETENCIES

Preferred Job Skills (Applies to All Levels)

Demonstrates an advanced knowledge of and experience with the development of business requirements, user stories, user acceptance testing and their supporting toolsets.
Familiar with HIPAA compliance validation tools such as EDISM, Specbuilder or ClarEDI.
Familiar with claims and customer service processes
Experience with web portal business user support and change management activities
Formal business analyst training

Preferred Professional Competencies (Applies to All Levels)

Driven to identify solutions to meet customer needs.
Ability to work with ambiguous and conflicting information while keeping focused on the end goal.
Performs public speaking presentations within the industry

Preferred Leadership Experience and Competencies

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

Blue Cross Blue Shield of Arizona

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