Business Analyst III

Overview

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. We strive to maintain an innovative and inclusive environment that allows employees to thrive.

When our employees succeed, the Company succeeds.

• Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is a senior level position working independently with guidance only in the most complex situations.
• 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 work groups 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.
• Coach/mentor less experienced staff, assist in onboarding of new staff and/or distribute and follow-up on work assignments.
• Perform other relevant tasks as assigned by management.
• Use multiple data sets to create reports, conduct analysis and research, identify trends and assist with the forecasting of products. Create databases, interactive reports and queries from multiple sources to provide reporting for various teams and leadership.
• Conduct root cause analysis and partner with IT to implement solutions and monitor results to completion.
• Partner with external vendors to reduce errors from billing reports, create efficiencies, reduce cost, and improve quality.
• Provide forecasting and analytics for enrollment vendors to ensure appropriate resource allocation. Reconcile vendor transactions billed in comparison to source systems. Ensure vendors are billed based on contractual obligations. Identify areas of opportunity with vendor billing and transactions and make recommendations to leadership.
• Provide first level support on  related issues. May create databases, monitor forecasting, summarize findings, and make recommendations for improvement.

• 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.
• May require knowledge of Horizon Blue Cross Blue Shield’s products and services.
• May require working knowledge of division operating plan and Horizon operating model.

• Some travel to the Penn Plaza office required

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range: $87,300 - $119,070

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case.

Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

This…