Business Systems Analyst I/II/III

Santa Clara Family Health Plan•San Jose, CA

23d•$85,740 - $172,310

About The Position

This posting is for one position and will be filled as either a Business Systems Analyst I or Business Systems Analyst II or a Business Systems Analyst III depending on the candidate qualifications and experience. We are looking for a BSA candidate who possesses strong technical skills with a focus on reporting and data analysis. The candidate should be skilled in SQL and have an understanding of programming languages to support code review and interpretation. The position will require adept critical thinking and problem-solving skills. The position will be responsible for developing and maintaining regulatory reports related to Case Management, Utilization Management, Claims, Members, Grievances, and Appeals. Business Systems Analyst I - The Business Systems Analyst I acts as a liaison between the business units, internal and external, including software development, production support teams, vendors and trading partners; develops and reviews small scale, basic business requirements, functional specifications, and business processes; participates in basic validation and testing of applications and reports, and provides support in the maintenance and improvement of SCFHP information management systems in support of SCFHP objectives and regulatory compliance. Business Systems Analyst II - The Business Systems Analyst II acts as a liaison between the business units, internal and external, including software development, production support teams, vendors and trading partners; develops and reviews small to medium scale, basic to moderate business requirements, functional specifications, and business processes; participates in basic to moderate validation and testing of applications and reports, and provides support in the maintenance and improvement of SCFHP information management systems in support of SCFHP objectives and regulatory compliance. Business Systems Analyst III - The Business Systems Analyst III acts as a liaison between the business units, internal and external, including software development, production support teams, vendors and trading partners; develops and reviews small to large scale, basic to complex business requirements, functional specifications, and business processes; participates in basic to complex validation and testing of applications and reports, and provides support in the maintenance and improvement of SCFHP information management systems in support of SCFHP objectives and regulatory compliance.

Requirements

Bachelor’s Degree in Healthcare, Information Systems, or related field, or equivalent experience, training, or coursework. (R)
Business Systems Analyst II - Minimum two years of experience as a business analyst. (R)
Business Systems Analyst III – Minimum four years of experience, training, or coursework. (R)
Business Systems Analyst II - Minimum one year of experience with healthcare management information systems. (R)
Business Systems Analyst III – Minimum of three years of experience with healthcare management information systems. (R)
Business Systems Analyst I - Ability to identify, troubleshoot, and resolve small-scale, basic business and systems issues. (R)
Business Systems Analyst II - Ability to identify, troubleshoot, and resolve small to medium scale, basic to moderate business and systems issues. (R)
Business Systems Analyst III - Ability to identify, troubleshoot, and resolve small to large scale, basic to complex business and system issues. (R)
Ability to organize work and present results in a professional manner. (R)
Business Systems Analyst II - Minimum one year of experience working with healthcare business processes. (R)
Business Systems Analyst III – Minimum three years of experience working with healthcare business processes. (R)
Business Systems Analyst II - Minimum one year of experience working with healthcare analytics and standard reporting measures. (R)
Business Systems Analyst III - Minimum three years of experience working with healthcare analytics and standard reporting measures. (R)
Business Systems Analyst I - Knowledge of project management standards and functions. (R)
Business Systems Analyst II - Minimum two years of experience utilizing project management guidelines and best practice. (R)
Business Systems Analyst III - Minimum four years of experience utilizing project management standards and functions. (R)
Business Systems Analyst II - Minimum two years of experience analyzing data for the purpose of informing business decisions. (R)
Business Systems Analyst III - Minimum four years of experience analyzing data for the purpose of informing business decisions. (R)
Business Systems Analyst I - Ability to document business requirements and processes following industry guidelines and best practice. (R)
Business Systems Analyst II - Minimum two years of experience creating industry standard business requirements and process documentation. (R)
Business Systems Analyst III - Minimum four years of experience creating industry standard business requirement and process documentation. (R)
Working knowledge of and the ability to efficiently operate all applicable computer software including a working knowledge of computer applications such as Outlook, Word and Excel. (R)
Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, providers and outside entities over the telephone, in person or in writing. (R)
Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
Ability to maintain confidentiality. (R)
Ability to comply with SCFHP’s policies and procedures. (R)
Ability to perform the job safely with respect to others, to property, and to individual safety. (R)

Nice To Haves

Business Systems Analyst I - Experience in healthcare. (D)
Business Systems Analyst I - Knowledge of healthcare management information systems. (D)
Business Systems Analyst I - Knowledge of healthcare business processes. (D)
Business Systems Analyst I - Knowledge of healthcare analytics and standard reporting measures. (D)
Business Systems Analyst I - Ability to analyze data for the purpose of informing business decisions. (D)

Responsibilities

Project and task management for small to large scale projects including: facilitate stakeholder and project team meetings, track actionable items, send regular project communications to team members and stakeholders, and escalate identified risks.
Troubleshoot small to large scale, basic to complex production system issues, including: thoroughly reviewing the initial service request, efficiently gathering additional information as needed from the service requester and subject matter experts, performing comprehensive critical thinking to identify root cause, documenting findings and resolution, and working with manager to determine appropriate escalation path, if applicable.
Process improvement and documentation for small to large scale, basic to complex projects; writing formal requirements and functional specifications following industry standards and departmental templates; creating process flow diagrams; overseeing implemented changes; communicating impact to affected business areas.
Responsible for following the SCFHP Project Life Cycle, Software Development Coding Standards, and Change Control Management policies and procedures.
Perform data validation on both inbound and outbound data sources. Document test cases and results.
Act as a resource for IT staff and business units ensuring quality, testing, and documentation.
Create and maintain basic to moderate SQL based reports to support business processes and initiatives.
Train, mentor and educate business systems analyst staff as needed on IT or healthcare topics.
Generate basic to complex source to target mapping documentation that clearly defines the data mapping and business rules applied between two systems.
Perform other related duties as required or assigned.