Business Systems Analyst (Remote)
Mass General Brigham Health Plan

Job Info

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Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

The Business Systems Analyst coordinates cross-functionally with stakeholders in Finance and throughout the organization to ensure that Analysts in the Actuarial, Underwriting, Risk Score Management, and Medical Economics areas have the appropriate systems, processes, data structures, documentation, and training in place to meet Mass General Brigham Health Plans' strategic objectives. S/he possesses in-depth knowledge of requirements gathering, data processing, health information systems, and solution design/testing. S/he independently produces technical documentation and training materials that clearly communicate complex and nuanced requirements in simple terms. S/he performs quality assurance testing on systems, datasets, analytic deliverables, and external regulatory reporting to ensure that documented standards are being applied.

Most of the work is conducted with minimal oversight or supervision. The Business Systems Analyst independently gathers requirements, configures systems, develops documentation, and follows up with stakeholders to ensure deliverables are clear, correct, utilized, and well understood. The Business Systems Analyst works collaboratively with staff, managers, and directors in Finance and other business areas, as applicable.

Responsibilities:

• Works collaboratively with Actuarial, Underwriting, Risk Score Management, and Medical Economics staff and managers to ensure standard protocols are documented and communicated:
  • Gathers and analyzes information from multiple sources to develop system and business requirements, data dictionaries, use/test cases, and decision trees
  • Assists in the translation of business objectives into data queries and analytic models
  • Creates a library of the specific data elements and analytic pathways used to answer common business questions
  • Actively participates in the configuration, implementation, testing, and upgrading of systems
  • Identifies opportunities for improvement of existing systems, data structures, and processes
  • Effectively interprets data and communicates findings/recommendations both orally and in writing appropriate to the audience
• Performs quality assurance testing on systems and datasets to ensure the accuracy and timely submission of reports and extracts to regulatory authorities such as CHIA, DOI, CMS, NAIC, and MassHealth
• Ensures the validity and accuracy of all data/information reported and presented
• Works collaboratively with IT to enhance automation of processes; establish data warehouse standards and definitions; and to identify new tools to facilitate standard querying and reporting
• Ensures data concepts/changes are well understood and best practices in data integrity are being applied throughout finance
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect
• Hold self and others accountable to meet commitments.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

Qualifications
Qualifications:

• Bachelor's degree required or the equivalent combination of training and experience, plus 4-6 years of business or systems analysis experience or 2-3 years of analytic and/or IT experience in healthcare.
• Prior experience working for a health plan or in a managed care setting preferred.

Skills/Abilities/Other Details:

• Possess strong analytic and technical skills and the ability to translate complicated data into useable information
• In-depth knowledge and understanding of health care claims data, coding schemes (ICD-9, CPT-4, DRGs), and risk adjustment
• Demonstrated knowledge of managed care concepts and the financial relationship between payors and providers
• In-depth knowledge and understanding of the various types of contractual relationships payors have with providers, including global and bundled payments and risk-sharing arrangements
• Demonstrated knowledge of database and data structures as well as of general systems technology
• Microsoft Office Suite and analysis tools (Visio, Word, Excel, PowerPoint, Teams, and SharePoint) preferred
• SQL: Ability to perform and execute querying/reporting functions preferred
• Cognizant Trizetto® product experience: QNXT and CCA desired.
• Electronic Data Interchange (EDI) experience desired.
• Organizational and project management skills to manage projects effectively; ability to manage multiple projects simultaneously
• Ability to work independently and in an efficient manner with minimal re-work including effective use of the peer review process
• Excellent verbal and written communication skills; outstanding interpersonal skills; the ability to relate positively with individuals at all levels both internally and outside of the organization
• Creative, flexible, and self-motivated with sound judgment
• Accountable for delivering high quality work with a commitment to service excellence
• Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner
• Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback
• Advanced proficiency with Microsoft applications; experience using business intelligence systems and/or query tools such as SQL and/or SAS
• Demonstrate Mass General Brigham Health Plans core brand principles of always listening, challenging conventions, and providing value.
• Bring fresh ideas forward by listening to and working with employees and the people we serve.
• Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner.
• Strong, demonstrated track record of an ability to execute on time, on budget, and on scope.
• Strong aptitude for technology-based solutions.
• Ability to inject energy, when and where it's needed.
• Current in healthcare trends.
• Demonstrated forward, visionary thinking; ability to see "what is" and envision "what could be."
• Ability to develop, introduce, defend, and gain support for a new ideas and approaches.
• Excellent leadership skills and leadership track record.
• Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required.
• Ability to view the long-range trends and cycles of the business and industry and see the "big picture."
• Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.
• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.
• Excellent interpersonal skills, including the ability to influence others at all levels of an organization.
• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
• Unquestionable integrity.
• Provides guidance to Network Management teams based on organizational goals and company policy.
• Motivates and encourages staff; leads through change and adversity. Makes decisions as needed and builds consensus as appropriate. Communicates and cascades information to employees in a timely manner and actively participates in the success of cross-organizational programs and initiatives.
• Sets clear goals and objectives and uses metrics to measure performance and hold staff accountable. Provides coaching to improve performance and holds regular development discussions with direct reports. Recognizes staff for their contributions.
• Inform, engage, inspire, motivate, and actively listen to employees.
• Make decisions that put the needs of the people we serve-our members, providers, brokers, and employers-front and center.
• Communicate and cascade information to employees in a timely manner and actively participate in the success of cross-organizational programs and initiatives.
• Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations.
• Hire, participate in, and/or recommend development measures and disciplinary actions up to and including termination; evaluate performance and supervise the work of all direct and indirect reports following established organizational policies, procedures, and practices.
• Set clear goals and objectives, use metrics to measure performance, and hold employees accountable. Provide coaching to improve performance and holds regular development meetings.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

The above statements are intended to describe the general nature and complexity of the work being performed by personnel assigned to this classification and do not represent an exhaustive list of all tasks, duties, and responsibilities required of personnel assigned to this position.

This job has expired.