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Pay Range:
$93,600.00 - $140,400.00 Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self.
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
Why this job matters:
Analyze complex technical issues and identify projects and technologies which will produce significant operational results and add value to the corporation. Conduct business requirements reviews and independently formulate logical statements of business requirements. Formulate and define technical scope to align with business objectives based on both user needs and technology strategy. Develop technical system specifications, resources and processes for a complex sub-systems or major systems modification.
What you will do:
Participate in business requirements sessions to define technical requirements. Gather technical requirements, ask probing questions, document findings, and incorporate feedback. Translate business needs into technical requirements. Formulate and define technical scope to align with business objectives based on both user needs and technology strategy.
Analyze and revise existing system logic difficulties.
Partner with business process experts to learn and understand problems or required changes with software. Develop detailed selection evaluation criteria based on identified IT product requirements.
Assume leadership role in defining technical requirements and solutions.
Create and/or assist in the creation of technical documentation that describe how systems should be created/modified to meet business requests. Review and approve the designs of vendors who create these types of documents.
Map business data elements to backend data sources.
Mentor technical analysts in methodology for defining and documenting technical requirements and defining technology roadmap.
Participate in functional specification and design reviews, validating technical aspects. Offer expert advice to technical staff.
Provide innovation to business areas and contribute to improve operational processes by advising in technical expertise.
Review and sign off on vendor delivered technical specifications.
Mentor less experienced staff.
Lead department projects and initiatives.
Perform other duties as assigned.
What you need to succeed:
A combination of education and related work experience
Experience creating technical documents
Knowledge of implementation and conversion activities
API and batch system expertise
Knowledge of modern web-based application design and client server technology
Strategic and critical thinking skills
Strong analytical skills
Strong business acumen and political savvy
Strong negotiation skills
Strong written and verbal communication skills
Strong problem-solving skills
Ability to work effectively with a wide variety of people in individual and group settings.
Strong organizing skills, with the ability to prioritize and respond to shifting deadlines.
Strong time management skills
Ability to manage diverse and deadline-oriented workflow.
The extras:
Bachelor’s degree in Computer Science, Information Systems, Business, or Engineering; or an equivalent combination of education and applicable work experience
Five to seven years of systems analysis experience, working on key business processes to define technical requirements.
Experience with Facets or other healthcare payor adjudication systems.·
Experience with NetworX Pricer or other healthcare claims pricing engine.
Experience with provider agreements, facility claim adjudication, service and procedure code setup.
Experience with groupers and editors such as 3M or Optum.
Healthcare or insurance experience.
Experience with Cloud based platform integrations: Azure, Google and Salesforce.
Experience with waterfall and agile software development methodologies
Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
In-office : onsite 5 days per week
Hybrid: onsite 2-4 days per week
Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.
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