G-TECH Jobs

Other Skills: 4 Key required skills:

• Extensive claims and benefits experience is required (NPS).

• Extensive Analysis and Design experience including process flow development in Visio.

• Healthcare industry experience is required.

• Ability to handle multiple projects concurrently.

• Reminder: When submitting candidates please include a response to the questions listed below.

• Please give an example of level of expertise you have with Claims?

• Do you have extensive experience in Analysis & Design, Data Mapping Document, and Functional Design Document? Please provide examples of kind of information included in these documents?

• Do you have at least 5 years of health care experience as a systems analyst in claims system?

• Please describe a functional process you designed in a clear organized manner.

ESSENTIAL DUTIES:

• Interacts directly with Business Leads, Delivery Lead, Vendors, and Technical Resources.

• Works independently within guidelines, provides analytical support to customers on business application, infrastructure and technology related activities.

• Provides guidance, assistance, coordination and follow-up on complex problems and ensures resolution.

• Works with other team members, systems analysts, to implement complex projects.

Experience submitting CSRs and follow-up with NASCO.

Work independently and or in a team with little or no guidance.

• Analyzes current business processes and systems to provide business process improvement ideas.

• Gathers requirements and develop detailed documentation related to systems requirements and conceptual solutions.

• Coordinates with testing center and other non- prime and prime areas.

Ability to work with and lead cross functional areas.

REQUIRED QUALIFICATIONS: 5+ years

• Extensive experience in Utilization Management and business functions. (Claims, NPS, Benefits, Pricing and Authorizations)

• Knowledge of the Healthcare industry.

• Excellent Communication Skills, both verbal and written.

• Extensive MS Office tools including Visio.

• Knowledge of SDLC/Waterfall/Agile.

• Interpersonal and leadership skills including the ability to work with both internal and external customers and all levels of the organization.

• Excellent problem solving, and conflict management skills including the ability to manage conflict and find mutually acceptable resolutions.

PREFERRED QUALIFICATIONS:

• NPS experience

COB experience is a plus.

Pricing experience is a plus

• Systems Analysis and Design experience

• Experience with Data Warehousing; Business Intelligence tools

Education/Certifications

o Bachelor degree required in Computer Science or Management Information Systems

o Master degree preferred in Computer Science or Management Information Systems.

Category Analyst

Function Information Technology

Req ID JN -032023-119797