Business Systems Analyst Lead

Business Systems Analyst Lead

22 Jun 2024
Pennsylvania, Philadelphia, 19107 Philadelphia USA

Business Systems Analyst Lead

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Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:
  • Analyzes processes and resources necessary for the effective implementation of stated processes.
  • Assists in managing large scale projects, leads appropriate resources and determines project requirements and deliverables, to ensure successful implementations to meet ACFC user needs.
  • Assists in ensuring successful project conclusions and large scale projects as measured by meeting ACFC Corporate objectives and large-scale projects.
  • Prepares feasibility and cost analysis determinations for projects.
  • Responsible for leading, evaluating and providing technical and project life cycle methodology.
  • Communicates business or process solutions, recommendations and issues to ACFC management on a regular basis.
  • Assists in development of training programs, introducing new concepts and business processes.
  • Documents all business process flows as they pertain to the continuance and efficiency of the IS Department.
  • Reviews software and systems modifications to ensure successful implementation.
  • Flows business processes.
  • Possess a sound understanding of issue resolution.
  • Develops innovative means of structuring project workflow to alleviate backlogs and ensure the maximum utilization of resources.
  • Anticipates and keeps manager and project staff informed of future or planned events which could impact implementations.
  • Interfaces with used with minimal supervision; and effectively and accurately communicates management policies and protocols.
  • Uses sound judgment compatible with established policies and procedures in matters where there is little precedent.
  • Develops a working knowledge of all ACFC Managed Care Activities: Marketing, Member Services, Health Services, Claims, Enrollment, Provider Relations, Finance, etc, in order to provide solutions and options to end users requests for service and problem solving.
  • Interacts with ACFC user areas, regularly, to discuss, observe and review tasks associated with their division as measured by successful implementation of project requests.
  • Interfaces with ACFC user to determine specific project requirements.
  • Conducts and evaluates business analysis.
  • Interfaces with users and management team, regularly, to provide status and user feedback.
  • Builds consensus among primary users, I.S. Department and senior management as it relates to large-scale business problems and issues.
  • Demonstrates a clear understanding and an accurate reflection of I.S. and ACFC goals, objectives, policies, procedures, and priorities.
  • Addresses the majority of inquiries independently, without substantial or recurring contact or excessive dependence on Manager.
  • Distinguishes between routine, significant, and sensitive matters or those issues for which direct response is inappropriate; and promptly apprises Manager.
  • Ensures requests are addresses promptly and courteously; honors commitments and demonstrates persistence in obtaining necessary information to address issues and problems.
  • Meets with external software vendors to discuss products and ensure ACFC requirements are satisfied.
  • Possesses ability to effectively communicate with senior and middle line management. Assists in cut over/implementation.
  • Demonstrates knowledge of management practice, protocols, and managerial principals in decision-making.
  • Understands the chain of command and points of accountability and decision for specific matter and communicates accordingly.
  • Decisions are consistent with, and proceed logically from, established programs and management policies, procedures, and protocols.
  • Demonstrates strong problem solving capabilities and approaches each problem in a logical and analytical manner with high degree of perseverance; produce definitive statement of the issues, and identification of alternative solutions, the pros and cons of each, the recommended course of actions, and the consequence of the decision.
  • Decisions, which are appropriately made, are normally effected with a minimal amount of inquiry and direction.
  • In Departmental decision, displays knowledge of alternative approaches and demonstrates the application of the appropriate alternative in each situation.
  • Displays an ability to anticipate and be responsive to management needs and exercise proper judgment in performing as part of the "Business Solution Team".
  • Responds promptly to requests for input on a variety of issues, such as budget preparations, operations objectives, reports, process re-engineering, business flow, etc.
  • Addresses the issues at hand thoroughly, accurately, and in a logical progression/flow of thought; correspondence and reports are articulate, grammatically and structurally correct; verbal presentations are handled in similar fashion.
  • Responses to management requests display a firm understanding of policies, procedures, and Plan mandates and operations.
  • Utilizes proper judgment relative to keeping superiors of specific problems of events which impact on departmental or overall ACFC business objectives.
  • Briefs management properly in those instances where problems are to be addressed by Senior Staff.
  • Updates and briefs staff, regularly.
  • In accordance with established regular communications with Manager, keeps staff apprised of progress, problems, and objectives, and initiatives discussions and solicits input regarding business priorities, plans, and progress.

Education/Experience:
  • Bachelor's Degree in Management Information Systems or related field or 8 years of related work experience.
  • Five (5) to ten (10) years of progressive experience in a business environment with project management and process re-engineering concentration.
  • Minimum of five (5) years direct user interface experience.
  • Ability to manage concurrent multiple tasks and projects.
  • Possess solid understanding of the industry; high level understanding of business application; sound understanding of organizational and process development.
  • High-level understanding of business computer programming and constructs. High work ethic, self- initiated learner, pro-active, high performer.
  • Previous experience in Pharmacy Benefits Management (PBM) is a plus.


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