Business Systems Analyst

1 month ago

United, United States Forhyre Full time
Job Title: Business Analyst

We are seeking a highly skilled Business Analyst to join our team at Forhyre. As a Business Analyst, you will play a vital role in supporting the successful completion of analytical, building, testing, and deployment tasks of our software product's features.

This role will work collaboratively with the Director of Claims to deliver timely and accurate payment of claims and first call resolution. You will also provide analysis related to the identification of improved claim system configuration and call flows that would positively impact quality performance, reduce claim inventory, and improve the customer experience.

Key Responsibilities:
  • Assist in the development of key performance indicators related to claim processing and call center performance.
  • Use existing technology to automate work distribution, create and maintain department metric dashboards.
  • Generate and distribute weekly/monthly/quarterly departmental reports to management and staff.
  • Summarize, create, and distribute operational, claim data, and call center metric reports as needed.
  • Ensure deliverables are completed on time; respond to changing project circumstances and communicate issues to project leadership.
  • Identify trends in data, including those that were not necessarily being actively monitored, which may have an impact on departmental performance and/or impact timeliness and the customer experience. Communicate actionable findings and provide recommendations as appropriate to management.
  • Work directly with managers and subject matter experts to refine and improve these tools for optimal efficiency and effectiveness.
  • Responsible for creating data definitions, validating data, retrieving data from systems, merging data from multiple sources, participating or reviewing technical documentation, report configuration, and coordinates project efforts as directed in order to achieve desired results.
  • Serve as a liaison to other departments (IS, Utilization Management, Provider Contracting, Provider Data Maintenance) that may include report creation, disseminating reports, and/or leading the implementation, maintenance, testing, and/or functional design of system changes.
Requirements:
  • Experience working with technology, systems, and IS departments.
  • Advanced Microsoft Excel skills.
  • Knowledge of ICD-10 and CPT-4 coding and medical terminology.
  • Proficient in Windows, Word, and Business Analytical tools.
  • Must have strong analytical and problem-solving skills.
  • Strong communication skills, including an ability to communicate with staff at various levels, including both front-line staff and senior management.
  • Must have excellent analytical, organizational, and interpersonal skills, as well as a strong background in pharmacy claims processing and the managed care industry.
  • Experience working within the Payer/PBM market (in particular Medicare and Medicaid, Part D, and its components) with understanding of benefit plan structures, NCPDP standards, HIPAA regulations, and other pharmacy products and services.
  • Must understand the workflow of pharmacy claim processing or related Med D functions. For example, Enrollment, Drug Utilization Review, Adjudication, Pricing, Payments/Billing, EOB, PDE, FIR, Reprocessing, or other features resident in or working in cooperation with a pharmacy benefit system.
  • Strong business knowledge of Pharmacy Benefit Systems and Drug benefit plan administration with exposure to COTS/custom applications would be an advantage.
  • Ability to effectively present information and respond to questions from clients, management, and technical associates.
  • Collaborate across the entire product team to ensure product dependencies, goals, and experiences are defined and met.
  • Document business requirements and user journeys.
  • Must have agile project execution experience along with familiarity to Scrum tools and methodologies.
  • Should have excellent verbal, written, documentation, and presentation skills.

Note: U.S. citizens and those authorized to work in the U.S. are encouraged to apply. We are unable to sponsor at this time.

  • Business Systems Analyst

    1 week ago

    Buena Park, CA, United States Royal Business Bank Full time

    JOB SUMMARYThe primary focus of Business Systems Analysis job function is to perform thorough analysis of business processes and technology, and customer and end-user needs to define functional and non-functional requirements for technology solutions. The Business Systems Analyst has the primary responsibility to elicit, analyze, validate, specify, verify,...

  • Business Systems Analyst

    1 week ago

    Austin, TX, United States Systems Integration Solutions Full time

    Business Systems Analyst (UKG Workforce Central)W2 Candidates Only!!No C2C!!Local Candidates Only!!Our direct client organization operates in several shared service centers around the world. They are seeking an experienced Business Systems Analyst, to support Company's global H2R Workforce Management Program. This roles responsibilities would also include...

  • Business Systems Analyst

    4 weeks ago

    United, United States Crescens Full time

    Job Title: Business Systems AnalystWe are seeking a highly skilled Business Systems Analyst to join our team at Crescens. As a Business Systems Analyst, you will be responsible for analyzing business needs and developing solutions to meet those needs.Key Responsibilities:* Analyze business requirements and develop solutions to meet those needs* Conduct...

  • Business Systems Analyst

    1 week ago

    Philadelphia, PA, United States Open Systems Technologies Full time

    A direct client of our located in Philadelphia, PA has multiple openings for Business Systems Analysts with Datawarehouse experience. This is a hybrid role onsite 2-3 days a week.The client's Data Warehouse team requires experience in creating Business Requirement Documents, Functional Requirement Documents and Mapping documents for the development of ETL...

  • Business Systems Analyst

    3 weeks ago

    United, United States First Commonwealth Bank Full time

    Job SummaryWe are seeking a highly skilled Business Systems Analyst to join our team at First Commonwealth Bank. The ideal candidate will have a strong background in business analysis and technology, with excellent communication and problem-solving skills.Key ResponsibilitiesAssist department managers in solving complex business problems and improving...

  • Business Systems Analyst

    3 weeks ago

    , NC, United States Compass Group, North America Full time

    Job SummaryThe Business Analyst will play a key role in the multi-year implementation of an ERP system upgrade across the Compass Group organization. This position is responsible for working within the Compass Sectors to gather and document business requirements for developing and implementing the ERP upgrade. The Business Analyst will work in a hybrid...

  • Business System Analyst

    7 days ago

    Minneapolis, MN, United States Insight Global Full time

    Title: Business System AnalystPR: $55-$60/hrLocation: Minneapolis, MN - 2-3 Days/Week In OfficeContract: 6 Month-HireDay to Day: As a Business System Analyst at RBC, you will analyze stakeholder requirements, develop plans, manage risks, and communicate with relevant parties. You will create IT documents, system specifications, and test plans. Your role...

  • Business Analyst

    1 week ago

    Jackson, MS, United States Apex Systems Full time

    Apex Systems is looking for a Business Analyst to join a growing team with a client in Jackson, MS. This is a 6+ month contract (chance to extend) that will sit in Jackson, MS office (5x per week) + occasional travel to client facilities across the Southeast (likely 1-2 weeks per quarter).The Business Analyst (BA) will elicit and document business...

  • Business System Analyst

    1 week ago

    Richmond, VA, United States Robert Half Full time

    Looking for a long-term opportunity with a financial institution? Want career stability at an organization that values your growth and cultivates your potential? Interested in a chance to make a difference on a business that is dedicated to continuous improvement?Due to organizational growth, a financial institution in Richmond is seeking a Business Systems...

  • Business Systems Analyst

    1 week ago

    Lawrence, MA, United States Alexander Technology Group Full time

    The Alexander Technology Group is looking for a Business Systems Analyst for a client in the Lawrence, Massachusetts area.This is an on-site position. No 3rd party c2c applicants will be considered****Contract to perm (6 months) Responsibilities include: Collaborate with stakeholders to elicit and document clear and comprehensive requirements for system...

  • Business Systems Analyst

    1 week ago

    Irvine, CA, United States Trusted Tech Team Full time

    Who We Are:Trusted Tech Team is a leading Microsoft Cloud Solutions Provider (CSP) specializing in Microsoft Cloud services, Microsoft perpetual licensing, and Professional and Security Services for medium and enterprise-sized businesses.Their robust team of in-house, U.S-based Microsoft architects and engineers are certified in all 6/6 Microsoft Solutions...

  • Business Systems Analyst

    3 days ago

    Lansing, MI, United States A-Line Staffing Solutions Full time

    Position Title: System/Business Analyst Want to apply Read all the information about this position below, then hit the apply button. Location: Lansing, MI (Hybrid, 2 days per week onsite) Rate: $45-55/hr on W-2 (No C2C or third-party candidates) Experience Requirements: 3+ years as a System/Business Analyst with experience in Joint Application Design...

  • Business System Analyst

    1 week ago

    Houston, TX, United States Emergent Professional Resources L.P. (EPR) Full time

    Our oil & gas client is looking to add an HR Business System Analyst to their team! As the HR Business System Analyst for Dayforce, you will serve as the administrator and primary support for Dayforce modules, including Benefits, HR, Payroll, Performance, Compensation, Learning, and Recruiting. You will work closely with various teams to ensure the effective...

  • Senior Business System Analyst

    7 days ago

    Danielson, CT, United States JVT Advisors Full time

    Full-time, on-site role. Excellent compensation, benefits and pension program. Prior manufacturing environment experience preferred. Prior ERP preferred. Prior project management preferred. The Business Systems Analyst works cross functionally with Subject Matter Experts the company’s global organization to envision, design and action the development of...

  • Senior Business System Analyst

    1 week ago

    Minneapolis, MN, United States Brooksource Full time

    Senior Business Systems Analyst Job Description:CHS is seeking a Senior Business Systems Analyst / IT Business Partner Administrator to join our IT Department and support our IT Business Partner (BRM) Team.If you excel in communication, are detail-oriented, and can thrive both in team settings and independently, this role is for you.Key...

  • WellSky Business Systems Analyst

    6 hours ago

    Phoenix, AZ, United States Idealforce Full time

    IDEALFORCE has a Contract position available immediately for a WellSky Business Systems Analyst to join our customer in Phoenix AZ. This is a Hybrid Please find below additional details about this job. Kindly respond with your most up to date resume if you would like to pursue this opportunity. Do you have the skills to fill this role Read the complete...

  • Senior Business System Analyst

    1 week ago

    Boston, MA, United States Eliassen Group Full time

    Senior Business Systems AnalystAre you energized by innovation? Do you want to combine the fast pace of a start up with the financial backing of one of the most successful companies in the industry? Then be part of an exciting new incubator within our Fortune 50 client's team that is geared at rapidly moving ideas from concepts to scale to help bring these...

  • GTM Business Systems Analyst,

    1 week ago

    Waltham, MA, United States Planet Technology Full time

    Duration: 3 months to start (likely extension or temp to hire potentially)Hours: 40 hours per weekInterview Process: 1-2 team interviewsLocation: Waltham (Hybrid - 2 days on-site) Backstory: Our client has transformational projects that will run through next year heavily focused on Salesforce, CPQ, NetSuite, BI work, etc. They are integrating the Germany...

  • IT ANALYST

    3 weeks ago

    Durham, NC, United States Duke Health Full time

    At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.About Duke Health Technology SolutionsPursue your passion for caring and innovation with Duke Heath Technology Solutions,...

  • Business Systems Analyst

    4 weeks ago

    , GA, United States Newtimes Group of Companies Full time

    About Newtimes:We're a dynamic company that values growth and talent. Our Distribution Center is the heart of our operations, and we're looking for a driven Technical Analyst to join our team. If you're a quick learner with a passion for technology and problem-solving, this could be the perfect opportunity for you.Role Overview:As a Technical Analyst, you'll...