Company :Highmark Inc.Job Description : 

JOB SUMMARY

***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***

This is a hybrid role. Candidates residing within 50 miles of Pittsburgh are required to work in the office on Tuesdays, Wednesdays, and Thursdays.

This role serves as a central point of accountability for vendor performance management, responsible for collecting, analyzing, and synthesizing data from across the enterprise to generate meaningful and actionable recommendations.  The role will identify opportunities to standardize vendor reporting, ensuring data accuracy in the central vendor repository, and providing feedback on reporting tools. A key aspect of this role is the ability to understand vendor contracts and terms to assist in preparing vendor budgets and defining relevant performance metrics. This role requires critical thinking, effective communication, data analysis, and strong organizational skills to evaluate vendor performance, provide strategic recommendations, and maintain effective communication with both vendors and internal stakeholders.

ESSENTIAL RESPONSIBILITIES

Intake operational objectives and gather information.  Define, understand, and manage project scope.  Perform moderate/complex research to support evaluation of complex output requirements and formats.   May translate more complex business initiates to less experienced employees. Present project deliverables to appropriate audiences.  Create reports on financial/operational performance.  Communicate business operational requirements to internal groups responsible for developing/testing business requirements in various applications.Coordinate, monitor, and report on the progress of projects to ensure adherence to defined project schedule.  Communicate effectively with customers and colleagues. Successfully articulate issues, problem, and solutions. Conduct and oversee pre and post-implementation review.  Successfully plan, design, and conduct functional walk-throughs.  Manage and advise on intermediate to large cross-functional projects and change initiatives involved in the design and delivery of business process solutions, implementation strategies, and control measures, including scoping, leading, and influencing organizational change related to business processes and models.Facilitate process improvement meetings and/or discussionsAnalyze the functions and operations of a business area/function and identify problem areas.  Create process mapping and documents current and future state business processes.  Act as subject matter expert/technical operations expert.  Recommend process efficiencies, strategies for improvement, and/or solutions to align technology with business strategies.Provide a broad range of budget, financial, and/or operational analysis for a large department or division. May develop budgetary/fiscal goal.Develop desktop procedures and training materials.  May train employees on new processes.May perform special projects upon request and oversee the work of less experienced employee. Other duties as assigned.

EDUCATION

Required

High School Diploma/GED

Substitutions

None

Preferred

Bachelor's Degree

EXPERIENCE

Required

5 - 7 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, customer service, etc.)

Preferred

3 - 5 years in the Health Insurance Industry

LICENSES AND CERTIFICATIONS

Required

None

Preferred

None

SKILLS

Analysis of business problems/needsWritten & Oral Presentation SkillsBusiness AnalysisBusiness Process DesignBusiness Process ImprovementBusiness Process MappingBusiness RequirementsCollaborative Problem SolvingProject Management

Preferred Skills:

Effective communicationCritical thinkingData AnalysisOrganization

Language (Other than English)

None 

Travel Required

0%  - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Never

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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