Business Systems Analyst

JOB SUMMARY

This role focuses on supporting the application product lifecycle, with a particular emphasis on claims processing and related application components. The Business Technical Analyst collaborates closely with customers, engineers, and other team members to capture capability needs, gather project specifications, and translate high-level business requirements into clear, comprehensive, and detailed specifications for new capabilities and enhancements on existing applications.

A key aspect of this position involves performing analysis of business problems and data to identify trends and opportunities for process improvement, particularly within claims operations. The incumbent will assist in creating and maintaining deliverables such as detailed requirements, user stories, and basic user interface designs. This role also actively participates in the full software development lifecycle on Agile Scrum teams, potentially contributing as a Business Technical Analyst or Tester.

The Business Technical Analyst supports all aspects of requirements testing, including scenario creation, documentation, and defect management. They will communicate effectively with team members and customers, assist with requirement walkthroughs, and provide project status updates. A critical responsibility is identifying and exploring opportunities for Artificial Intelligence (AI) and automation solutions within the claims domain and assisting in their implementation. The role requires an understanding of the impact of changes across multiple interconnected systems to support seamless integration, and will assist in identifying, documenting, and managing project risks, defects, and issues to ensure quality delivery. This position also involves staying informed on market trends, particularly in claims technology, to support business value statements.

ESSENTIAL RESPONSIBILITIES

• Work with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, requirements and personalization to different clients, and user interface design.
• Participate in the full software development life cycle by actively participating on Agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need.
• Support various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. 
• Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle.
• Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
• Other duties as assigned.

EDUCATION

Minimum

• Bachelor's Degree in Business Management, Information Systems, or closely related field

Substitutions

• None

Preferred

• None

EXPERIENCE

Minimum

• 3 - 5 years in IS/IT

Preferred

• 1 - 3 years in Lean/Six Sigma experience
• 1 - 3 years in the Health Insurance Industry
• 1 - 3 years in the Healthcare industry

Certifications & Methodologies:

• Agile Methodology Certification (e.g., CSM, CSPO).

Technical Knowledge:

• Familiarity with open systems technologies.

Industry & Technology Trends:

• Awareness of emerging healthcare IT regulations and trends.
• Exposure to claims processing software or platforms (e.g., Facets, Amisys, HealthRules).
   

LICENSES OR CERTIFICATIONS

Required

• None

Preferred

• Information Technology Infrastructure Library (ITIL)
• The Open Framework Group (TOGAF)
• Six Sigma
• Project Management Professional (PMP)

SKILLS

• Analytical Skills
• Problem-Solving
• Communication Skills
• Report Writing
• SQL
• Agile Methodolgy
• Agile Project Management

Language Requirements (other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Rarely

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

Occasionally

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

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Rarely

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

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 position 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.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

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.

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