Systems Analyst - Claims

Systems Analyst - Claims

Detroit

• Michigan

Systems Analyst

Contract

We are seeking a REMOTE Advanced Systems Analyst to work in the Health Plan field.

Job Overview

Plan, develop, test, and implement IT system solutions that improve business efficiency and productivity as well as support business strategies and goals.

Key Responsibilities

• Plan, develop, test, and implement IT system solutions that improve business efficiency and productivity while supporting business strategies and goals.

• Identify and communicate business needs and translate business requirements into technical system and functional specifications.

• Support highly complex or critical business processes and systems, including the design or integration of technical solutions across multiple business functions.

• Participate in large, highly complex projects that may be enterprise-wide.

• Ensure effective and efficient onboarding and rollout of claims application functionalities.

• Assist in troubleshooting system issues related to claims processing.

• Attend industry-standard work groups.

• Collaborate with business users and quality analysis teams to ensure effective system integration and implementation.

• Perform data analysis and validation.

• Align technology solutions with business strategies involving moderate to complex business processes.

• Work with business unit managers, project managers, Agile teams, and business stakeholders to identify and capture business problems and non-functional requirements.

• Clearly communicate organizational options through business cases, making full use of external research and industry-specific trends.

• Develop materials and present results from pulled reports.

• Translate business requirements and user stories into functionality and features.

• Assist teams in performing technological assessments and developing recommendations based on business relevance, appropriate timing, and deployment.

• Develop recommendations for resolving problems and review recommendations with the team.

• Work closely with developers and end users to ensure technical compatibility and user satisfaction.

• Assist with agenda setting and project prioritization for planning sessions.

• Serve as a key business unit partner by identifying requirements, facilitating and managing requirements and user story discovery sessions, and driving the development of session documentation.

• Collaborate with teams on systems and process automation planning to align with industry best practices and meet business and IT needs.

• Coach employees on making effective use of technology and information when necessary.

Qualifications and Requirements

Departmental Preferences

• Four (4) to six (6) years of relevant system solution development, testing, and implementation work experience required.
• Strong written and verbal communication skills, including technical writing.

Healthcare Insurance and Claims Knowledge

• Basic functional knowledge of end-to-end claims processing.

• In-depth knowledge of the insurance industry, including members, eligibility, claims, and related processes.

• In-depth knowledge of business operations, systems requirements, development methodologies, and IT processes and technologies.

Technical skills:

• Systems Development Life Cycle (SDLC)

• Structured Query Language (SQL)

• Quality Assurance (QA)

• Requirements Gathering

• Functional Specifications

• Advanced Analysis

Education and Experience

• Bachelor's degree in a related field preferred, or equivalent work experience.

Systems Analysis and Technical Skills

• Experience eliciting requirements and performing testing.

• Experience translating customer journeys into user stories.

• Knowledge of Agile, DevSecOps, and Design Thinking methodologies.

• Familiarity with standard and emerging IT processes, tools, and frameworks.

• Knowledge of information gathering, planning, and organizing methods and principles.

• Experience analyzing data to draw business-relevant conclusions.

• Experience with data visualization techniques and tools.

• Ability to conduct research into a wide range of computing issues as required.

Analytical, Communication, and Organizational Skills

• Strong technical, analytical, and interpersonal skills.

• Fundamental analytical and conceptual thinking skills.

• Ability to influence stakeholders and work closely with them to determine acceptable solutions.

• Excellent planning, organizational, and time management skills.

Why work with us? We are a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work with us you'll have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! We are an EOE, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. https://www.optechus.com/eeo_self_identification/

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