Business Analyst III-DSNP Quality

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.
Knowledge of Healthcare industry required.
Knowledge of Project Management methodologies.
Excel Proficiency strongly preferred.

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.
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.

May require knowledge of Horizon Blue Cross Blue Shields products and services.
May require working knowledge of division operating plan and Horizon operating model.