Blue Cross and Blue Shield of Louisiana Enrollment Solutions Analyst in Baton Rouge, Louisiana
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POSITION PURPOSE :
Responsible for advanced operations related to enrollment integrations with strategic partners. Serve to develop and coordinate enrollment. Ensure solution design, data quality, integrations and business processes meet business objectives. Review and evaluate existing solutions and processes to develop data-driven recommendations to improve performance for both quality and timeliness.
NATURE AND SCOPE :
This position reports to Manager, Membership and Billing or Mgr, Dental Operations
ACTIVITIES OF DIRECT REPORTS:
This position has no direct reports.
In order to effectively fulfill this position the incumbent must be in contact with:
Information Technology, Business Engineering Team, Customer Service, Claims, Marketing, Underwriting, other departments within BCBSLA, and solution partners.
Bachelor’s degree in a business-related field is required. Four years of experience in healthcare operations may be used in lieu of a degree.
Minimum 3 years of experience in system administration, analysis or operations.
Experience in project management preferred.
Understanding of interdependencies between business processes and system functionality.
Demonstrated leadership qualities and the ability to work independently.
Strong organizational and analytical abilities.
Excellent written and verbal communication, presentation and effective interpersonal skills.
Ability to recognize inconsistencies and gaps in business processes and take appropriate corrective actions.
Experience in developing system solutions related to healthcare and membership/enrollment administration preferred.
Experience in developing detailed business requirements and test cases, and reviewing/approving of test case results.
Experience in coordinating and facilitating implementation of new solutions and changes to existing solutions including working with other applicable resources on training content, policy and procedure documentation.
The list below is a summary of the primary accountabilities of the incumbent. It is not intended to be a comprehensive listing of all duties and responsibilities. Contents are subject to change at management’s discretion.
Identify and evaluate system/process deficiencies and make necessary enhancement recommendations to improve outcome and performance.
Develop comprehensive business requirements to meet customer needs, process efficiency, quality control, reporting requirements, security restrictions.
Develop and coordinate test plans and test cases for new and modified solutions
Coordinate with testers during testing phases including review and approval of test results.
Request, document, test, evaluate, and approve programming changes to processing systems to ensure operational goals of the system enhancement.
Serve as advisor to develop business requirements.
Work with other internal personnel, external agencies and vendors as necessary to gather information required to support decisions and resolve complex issues.
Serve on project committees and workgroups as a means of defining complex issues, perform necessary research into the issue and provide recommendations to workgroups as a subject matter expert to ensure accurate and efficient handling of tasks such as enrollment and project development.
May monitor progress of major membership/enrollment enhancement to support departmental and corporate objectives.
May communicate system and process changes to the documentation specialist to ensure timely updates of policies and procedures.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
An Equal Opportunity Employer
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To improve the lives of Louisianians by providing health guidance and affordable access to quality care.
Blue Cross and Blue Shield of Louisiana (BCBSLA) is fully aware of the increasingly urgent national issues regarding the affordability of healthcare, the numbers of uninsured and the quality of health services rendered. BCBSLA is active at providing education and guidance, thereby helping to shape the healthcare reform legislation.
Consistent with its mission and the leadership role BCBSLA plays within the healthcare community of Louisiana, BCBSLA will collaborate with other business and community leaders to move Louisiana to a quality-driven model of healthcare. Such a model will engage the powerful forces of well designed information, patient engagement, provider professionalism and financial incentives to improve health outcomes, eliminate wasteful and preventable care, enable greater universality of care, and promote patient-centered care which addresses diverse patient needs and values.
Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana.