Job Title: Business Analyst I
Location: Newark, NJ
Zip Code: 07106

Description:

Job Summary:

This position is responsible for conducting research and root cause analysis for the department with the goal of recommending and implementing new processes and solutions to problems which resolve issues and improve operational performance. This position will also provide technical support to the department and act as liaison with IS(Information Services) for new system enhancements.

Responsibilities:

1. Analyzes and performs root cause analysis on the error trends identified from focus audits.
2. Performs analysis necessary to document system problems and recommend viable solutions, including intermediate workarounds.
3. Coordinate the development and testing of system specifications.
4. Assist with implementation of new business, products or contracts on the system through review of system files and testing of benefits.
5. Researches, develops and manages the accurate and timely validation of the system
workflows and procedures to ensure their adaptability to operations activities.
6. Prepare reports as needed, (i.e. trend analysis) to monitor progress of new processes for timeliness and quality.

Compliance Statement:
Demonstrates knowledge and understanding of the laws, regulations and policies that pertain to the organizational unit's business and conforms with these laws, regulations and policies in carrying out the accountabilities of the job.

Core Competencies:
The target competency level for the PROFESSIONAL role is "Applying" for the following core competencies.
- Analytical Thinking
- Business Savvy
- Managing Change
- Multidirectional Communication
- Service Quality
- Shared Leadership
- Speed and Agility
- Team Work
- Technology Proficiency

Qualifications:

Education/Experience:
1. Requires a Bachelor's degree. Internal applicants lacking a degree but who have related
business experience and who have demonstrated performance above the contributor level will
be considered.
2. Require one (1) to three (3) years experience in Health Insurance, preferably in a customer service and/or claims processing environment.
3. Requires managed care contract experience.

Knowledge:
1. Require knowledge of the Blue Care Link, Nasco or New Membership System (NMS).
2. Require knowledge of health insurance operations area such as claims, service or membership and medical policy.
3. Requires knowledge of medical terminology.
4. Requires knowledge of the managed care environment.

Skills and Abilities:
1. Require excellent written and oral communication skills.
2. Requires the ability to communicate in a clear and concise manner.
3. Require strong PC skills including spreadsheets and word documents.
4. Requires excellent organizational skills.

Special Licenses and Certifications:
The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.

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