Jobs
>
New York City

    Business Analyst III - Newark, United States - Horizon Blue Cross Blue Shield of New Jersey

    Horizon Blue Cross Blue Shield of New Jersey
    Horizon Blue Cross Blue Shield of New Jersey Newark, United States

    1 week ago

    Default job background
    Description

    Job Description

    Job Description

    Job Title: Business Analyst III

    Job Description Summary

    Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is a senior level position working independently with guidance only in the most complex situations.

    Responsibilities:

    • Investigate service related issues to identify root cause of issues; identify and communicate business needs assessments as necessary.
    • Develop forecasting tools using current technology/systems (Access, Excel, Monarch, etc.)
    • Translate business requirements and assist IT with the development of technical specifications.
    • Develop solutions based on data analysis to increase business efficiency.
    • Lead or participate in internal and external project workgroup(s) and presentations.
    • Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc.
    • Prepare materials for internal and external audit activities; review audit findings/reports for accuracy and completeness. If appropriate, formulate rebuttal and/or corrective action steps.
    • May coach/mentor less experienced staff, assist in on-boarding of new staff and/or distribute and follow-up on work assignments.
    • Perform other relevant tasks as assigned by management.


    ADDENDUM FOR QUALITY AUDIT MEASUREMENT TEAM ANALYSTS:

    • Identifies process improvement opportunities for platform work as an example, review SQM and QA reports, review trends to identify process improvement and automation)
    • Gather, process FCR and QA performance data and conduct trending and root cause analyses
    • Design and develop standard reports for metrics reporting and analysis. Document call center processes using standard techniques.

    ADDENDUM FOR MEDICAL POLICY TEAM ANALYSTS:

    • Apply professional and facility billing procedural (CPT/HCPCS) and diagnostic (ICD10) knowledge to support new cost savings opportunities.
    • Apply vendor clinical coding rule knowledge to support reimbursement and medical policy criteria and claims processing.

    Disclaimer:

    This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

    Education/Experience:

    • High School Diploma/GED required.
    • Bachelor degree preferred or relevant experience in lieu of degree.
    • Minimum of seven (7) years' experience in an operational role, or analytical role.
    • Experience with relational databases. SQL experience HIGHLY preferred which includes writing and analyzing SQL queries.
    • Experience with backend/frontend technologies preferred (JAVA, J2EE, UNIX, EJB, JavaScript, CSS, etc.)

    Knowledge:

    • Knowledge of Healthcare industry required.
    • Knowledge of Project Management methodologies.
    • May require knowledge of Horizon Blue Cross Blue Shields products and services.
    • May require working knowledge of division operating plan and Horizon operating model.
    Company DescriptionHorizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.
    We are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).

    Company Description

    Horizon BCBS NJ is New Jersey's largest and #1 Rated Healthcare Managed Care Company.\r
    We are a not for profit company that is highly rated (Forbes List 2024-One of the Best employers in the US).
  • Horizon Blue Cross Blue Shield of New Jersey

    Analytics Analyst III

    1 week ago

    Horizon Blue Cross Blue Shield of New Jersey Newark, United States Full time

    Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · The Analytics Analyst III will partner with multiple customers to provide more complex resolutions to analytics/data problems (i.e. linear models, pattern analysis, ...

  • DelDOT

    Management Analyst III

    3 weeks ago

    DelDOT Newark, United States

    Introduction · Make a Difference with DHSS · Our mission at the Department of Health and Social Services (DHSS) is to improve the quality of life of Delaware citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. We prior ...

  • Memorial Sloan

    Financial Analyst III

    2 weeks ago

    Memorial Sloan New York, United States

    · Financial Analyst III - Information Technology · Job Locations · USA-NY-New York · Requisition ID · Category · Professional - Finance · Pay Range · $88,800.00-$142,200.00 · Pay Range · $88,800.00-$142,200.00 · Company Overview · The people of Memorial Sloan Kettering Cancer Ce ...

  • Memorial Sloan Kettering Cancer Center

    Financial Analyst III

    2 weeks ago

    Memorial Sloan Kettering Cancer Center New York, United States Full time

    Pay Range: $88,800.00-$142,200.00 Company Overview: The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed b ...

  • Memorial Sloan Kettering Cancer Center

    Financial Analyst III

    2 weeks ago

    Memorial Sloan Kettering Cancer Center San Francisco, United States Permanent

    Pay Range: $88,800.00-$142,200.00 Company Overview: The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed b ...

  • Rightway Inc

    Data Analyst III

    1 week ago

    Rightway Inc New York, United States

    ABOUT THE ROLE: · We are seeking a full-time Data Analyst III to join our Data & Insights team. In this role, you'll be responsible for creating data analyses that demonstrate our company's impact to clients and strategic partners. You will support the development and execution ...

  • Building Service 32BJ Benefit Funds

    Business Analyst III

    2 days ago

    Building Service 32BJ Benefit Funds New York, United States

    Job Description · Job DescriptionAbout Us: · Building Services 32BJ Benefit Funds is the umbrella organization responsible for administering Health, Pension, Retirement Savings, Training, and Legal Services benefits to over 100,000 SEIU 32BJ members. Our mission is to make signi ...

  • Memorial Sloan Kettering Cancer Center

    Financial Analyst III

    2 weeks ago

    Memorial Sloan Kettering Cancer Center New York, United States

    Company Overview · The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloa ...

  • City of New York

    Procurement Analyst III

    3 days ago

    City of New York New York, United States Full time

    OPEN TO PERMANENT PROCUREMENT ANALYSTS OR INDIVIDUALS IN A COMPRABLE CIVIL SERVICE TITLE · The Office of Chief Medical Examiner investigates cases of persons who die within New York City from criminal violence, by accident, by suicide, suddenly when in apparent health, when unatt ...

  • Innova Solutions

    IT Security Analyst III

    4 weeks ago

    Innova Solutions New York, NY, United States

    Innova Solutions is immediately hiring for an Information Security Analyst. · Full-time | Contract to Hire · Location: New York, NY (Hybrid - 3 days in the office) · As an Information Security Analyst, you will: · Reviews and analyzes complex data and information to provide in ...

  • Orangepeople

    Data Analyst III

    2 weeks ago

    Orangepeople New York, United States

    Job Description · Job DescriptionThis role requires exceptional communication skills, operational efficiency, and attention to detail. The Data Analyst will be responsible for managing the data quality of Scaled Partnerships programs and providing comprehensive reporting to enhan ...

  • TEKsystems

    Data Analyst III

    1 week ago

    TEKsystems New York, United States

    : · Role Responsibilities including but not limited to: · • Provide detailed and comprehensive reporting of vendor management efficiency on a regular basis to keep stakeholders informed · • Act as the primary liaison for stakeholders to ensure clear and effective communications r ...

  • Innova Solutions

    IT Security Analyst III

    4 weeks ago

    Innova Solutions New York, NY, United States

    Innova Solutions is immediately hiring for an Information Security Analyst. · Position type: Full-time | Contract to Hire · Duration: 12 months · Location: New York, NY (Hybrid - 3 days in the office) · As an Information Security Analyst, you will: · Reviews and analyzes comp ...

  • Alpha Net

    Data Analyst III

    3 weeks ago

    Alpha Net New York, United States

    Job Description · Job DescriptionData Analyst - HR Technology · The Insights Analyst is responsible for sourcing data and producing accurate timely reporting in support of the Privacy, Risk Compliance Group as well as other ad hoc analytics assignments. The candidate should be sk ...

  • The Ladders

    Financial Account Analyst III

    2 weeks ago

    The Ladders New York, United States

    · Position at MTA Headquarters · JOB TITLE: Financial Accounting Analyst Level I, II, III - Lease Accounting and Fixed Assets · DEPT/DIV: Controller's Office · SUPERVISOR: Senior Manager - Lease Accounting and Fixed Assets · LOCATION: 2 Broadway · HOURS OF WORK: 9:00 am - 5 ...

  • Mount Sinai Hospital

    Data Science Analyst III

    1 day ago

    Mount Sinai Hospital New York, United States

    Job Description · The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated analytics to provide information, insights and BI (Business Intelligence) solutions that contribute to sound strategic planning, ...

  • AIG

    Claims Analyst III – Financial Lines

    3 weeks ago

    AIG New York, United States Full time

    Who we are · American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial service ...

  • AECOM

    Project Controls Analyst III

    1 week ago

    AECOM New York, United States

    **Company Description** · **How will you make your mark?** · At AECOM, our work in providing access to clean water enables communities to thrive and ecosystems to flourish, contributing to a resilient future. As a global leader in infrastructure consulting, we are at the forefr ...

  • Raymond James Financial Services

    Investment Banking Analyst III

    1 week ago

    Raymond James Financial Services New York, United States

    Under administrative direction, uses extensive knowledge and skills obtained through education and experience to work with a variety of financial products, including public and private debt and equity financings, mergers and acquisitions and financia Investment, Banking, Analyst, ...

  • Russell Tobin

    IT Business Analyst III

    6 days ago

    Russell Tobin Jersey City, United States

    · What are we looking for in our IT Business Analyst III - Daily? · Title: Senior Business Analyst · Duration: 12 Months · Location: Jersey City, NJ (Onsite) · Pay Range: $650/ Daily to $700/Daily (As per experience) · Candidate Success Factors: · Candidates to be measured on t ...