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Principal Health Plan Business Systems Analyst

Bloomington, MN
NorthShore Resources has contract to hire opportunity for a Principal Business Systems Analyst. This role will direct and participate in the analysis, business technical design, testing and implementation of system enhancements to core administrative systems, departmental surround applications, and system control environments. The BA provides consultative services to system users and stakeholders upon request. The BA also serves as a liaison between internal team members from assigned business operations and IS&T departments, as well as applicable system software vendors. The BA may be assigned project management responsibilities on large and/or complex system projects. To be considered, candidates must be currently working/living in MN

What We Expect From You
Knowledge Level:
  1. Serves as technical subject matter expert on multiple health plan administrative systems.
  2. Possesses expert knowledge of assigned systems/business operation functions including: system functional capabilities, data interfaces to/from other applications, system outputs, database structures, business processes and procedures, applicable national medical code sets, and relevant federal and state regulatory requirements.
  3. Expert in one or more federal HIPAA health plan transaction standards.
Core Administrative System Fixes/Enhancements
  1. Serve as business systems technical project lead for implementation of large* and/or complex system enhancements/fixes.
  2. Analyze business users needs and requirements and lead the planning, design and development of core administrative systems or devise ways to apply existing systems to additional operations or specialized programs
  3. Responsible for the creation of highly detailed business requirements documents for large/complex system fixes/enhancements and required systems control environments. Obtains required business requirements sign-off from business operations and IS&T staff.
  4. Participates in the development and review of IS&T technical systems design recommendations to validate that system functionality is in alignment business requirements.
  5. Assists in the evaluation of potential operational impacts and works with business operations staff in identifying and documenting changes to current business workflows.
  6. Develop systems testing strategy and test plan documents, including identification of required test scenarios and expected results. Review test plan with business operations staff to validate accuracy of test plan.
  7. Conduct required business user system testing and, if needed, review results with business operations and IS &T contacts to obtain final user acceptance testing sign-off.
  8. Work with IS& T and business operations staff to identify implementation tasks and schedule date for system fix/enhancement installation.
  9. Directs and/or participates in the development of user manuals, technical systems documentation, and business operational procedures.
  10. Develop post-implementation strategy and conduct monitoring to validate successful implementation of system fix/enhancement.
* Large system fixes/enhancements require greater than 750 hours if IS & T programming time. Changes may affect multiple system applications and business department across the health plan and development/implementation must be coordinated with all affected project constituents.
Major Projects
  1. Ability to describe a process as a collection of steps that covers both the system and the Actor’s perspective.
  2. Must be able to articulate, handle and manage the intangible and most importantly, communicate effectively.
  3. With minimum supervision, serves as project team leader or project manager and directs large or very complex projects as assigned by the Sr. Director and/or Manager, AOD.
  4. Works with the user community and other AOD personnel to develop and achieve project objectives, deliverable schedules, system test and acceptance criteria, and training and education.
  5. Directs programming activity, monitors project schedules and recommends changes as necessary to the project leader.
  6. Verifies compliance to system plans and specifications and reports progress against project schedules.
  7. Provides technical and process guidance and supervision to team members to ensure projects meet all defined requirements and are delivered on schedule.
Report Generation
  1. Knowledge of database design and concepts
  2. Interact with business owners in the organization to understand current and future requirements
  3. Proactively and independently formulate actions plans to resolve problems
  4. Design, program and test required report(s) using appropriate report generation software tool.
Required Qualifications
  • Bachelor's degree in Computer Science, Business Administration, Management Information Systems or equivalent. Applicable previous experience may be considered for this qualification.
  • 5+ years experience in business systems analysis and/or systems development.
  • 5+ years demonstrable experience working as a Business Analyst with Product Owner experience in healthcare operations
  • 5+ years working with stakeholders, partners and gathering requirements •
  • 5+ year Agile Methodology and Tools experience
  • 3+ years' experience with BI / Data warehouse analyst
  • Experience working with BI Software; familiarity with UI designing.
  • 3+ years' experience with SQL, with demonstrated ability to derive insights through efficient SQL queries
  • Experience working with Financial Systems
  • Project management experience as business lead successfully meeting large or very complex project deliverables and timelines on multiple projects. Includes managing a major project (1000+ hours) from initiation through successful implementation and acceptance.
  • Expertise in CQI, system development methodologies and data object mapping.
  • Experience and proficiency in/with
    • multiple health plan administrative systems
    • interpreting system data models
    • database applications and end-user software
    • analytical and reporting tools
  • Excellent communication skills in technical and non-technical topics.
  • Excellent analysis and problem solving skills.
Preferred Qualifications
  • Fourth generation program language (4GL) experience (i.e. SQL, Crystal Reports, Visual Basic, Business Objects, etc.).
  • Expertise in multiple health plan administrative operational areas.
  • Experience using MS Office applications, flowcharting tools, and/or other project management tools.
  • Two or more years of experience with continuous quality improvement concepts and methodologies.
  • Experience working with multiple health plan administrative systems.
  • Experience with various electronic processes and systems including external and internal interfaces and systems integration.
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