Business Systems Consultant
1 month ago
Job Summary
This position is responsible for the strategic implementation of business infrastructure systems that support the Medicaid Business Unit market served by Highmark. The successful candidate will perform configuration change management activities related to benefits, business rules, screen design, and functionality, as well as translate configuration rules, fee schedules, and contract terms into systems parameters to ensure accurate managed care operations.
Key Responsibilities
- Lead in working with customers, software engineers, architects, and other team members to capture capability needs and drive quality business solutions.
- Participate in the full software development life cycle, including agile scrum teams, and provide required business and/or subject matter expertise on most complex issues.
- Ensure compliance to required standards and all necessary approvals have been obtained throughout the project lifecycle.
- Interface with business areas, customers, partners, vendors, technical staff, and project teams to drive value, return on investments, and innovative solutions.
- Lead in supporting various aspects of requirements testing to ensure minimal production defects are realized.
Requirements
- Bachelor's Degree in Business Management, Information Systems, or closely related discipline.
- 7-10 years in IS/IT, 3-5 years in Project Management, and 3-5 years in the Health Insurance Industry.
- Experience with HealthEdge HRP, hands-on configuration experience, and knowledge of Medicare & Medicaid programs and their benefits.
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