Lead Business Analyst, Medical Care Solutions

Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission‑driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution. We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever‑changing healthcare space. Come and help us make health care better for everyone. Responsibilities Support Care 1st Utilization Management and Pharmacy Services teams in the implementation and continued maintenance of a benefit authorization system. Provides analytical support through the analysis and interpretation of data in support of cross‑functional business operations. Identifies opportunities for improvements and works cross‑functionally to design and develop business solutions. Provides analytical support to multiple projects, establishing project documentation and timelines and coordinating on projects with internal and external resources. Defines complex business requirements and provides analysis to increase operational efficiency. Facilitates and documents business requirement and testing sessions. Organizes departmental meetings to identify, analyze and resolve complex cross‑functional challenges. Identifies opportunities for improvement in operational performance and notifies management of issues and problems requiring immediate attention. Identifies and documents test scenarios; coordinates the execution of test cases and records test results for SIT, UAT and monthly releases. Analyzes actual results against plan and forecast and recommends interventions where appropriate. Develops, prepares and analyzes, and presents reports for management review. Works under limited supervision. Effectively communicates and builds/maintains strong relations with operational partners including vendor partners to ensure specific needs are met. Translates business needs into technological requirements to ensure business needs are addressed. Directly configures supported applications to ensure business needs are met (configuration training will be provided). Qualifications Five (5) or more years experience in health care setting with Bachelor's degree, or equivalent combination of education and experience. Additional Skills Strong working knowledge of Visio and Excel. Strong analytical and problem‑solving skills. Strong communication skills (written and verbal). Knowledge of/experience using Agile development methods. #J-18808-Ljbffr Blue Shield of California