Friday, February 22, 2013

[SMCNG] Digest Number 1068

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Digest #1068

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Fri Feb 22, 2013 2:24 pm (PST) . Posted by:

"john sampson" jcsspike

Reply to the Horizon BCBS web site
 
Job Summary:
 
Subject matter expert in a business domain and working in a matrix environment, to understand, help define, analyze, design, implement and maintain business process and IT capabilities to support HHI pilots. Maintain a comprehensive understanding of the current IT and business process capabilities in their assigned business domain, as well as, external best practices and vendor offerings. Partner with the innovation teams and pilot capabilities managers to identify, document, analyze and prioritize pilot needs in their particular business domain. Partner with a Capabilities Domain Manager and Horizon domain expert in the business and IT to develop, short and long-term strategies to design, implement and maintain pilot technical and business process capabilities that may either be integrated with Horizon-BCBSNJ or be unique to HHI.
 
Responsibilities:
 
Provide guidance to the Capabilities Analyst I position.
Facilitate and document meetings to capture requirements, assess solution options, develop recommendations and capture action items.
Analyze risks, identify trigger events, and establish contingency plans and risk mitigation actions.
Track progress of work tasks and report on status and issues.
Guide and support Capabilities Analyst I with their assignments.
Assess merits of implementing automated vs. manual or semi-automated solutions
Document, analyze and development current and future state business processes
Work with counterparts and stakeholders in Horizon and with vendors and partners aligned to other departments and initiatives.
Understands pilot objectives, stakeholders and business rationale
Conducts detailed research in specified domain area (and related areas) to understand Horizon, external best practice, competitor and vendor business processes and IT capabilities
Acts as Subject Matter Expert in business domain and associated technologies to help influence pilot blue printing and pilot high level requirements
Contributes to and facilitates business requirements gathering process across pilots, including the creation of deliverables; review of BRD and TRD.
Leads and owns the analysis and resolution of complex issues and coordinates the documentation of business needs
Assess short and long term options to meet pilot and cross pilot needs considering an appropriate balance between value delivered to pilots against the cost and complexity of capability delivery.
Support HHI pilot teams in the selection and implementation of tools and manual workarounds to support pilot models
Document pros and cons of various options and present a recommended solution
Contribute to short and long term capabilities development strategy in assigned business domain
Engage all necessary internal and external parties to resolve gaps in processes, system integration, reporting required to implement the pilot(s).
Understand and leverage best practices for delivering viable technical solutions
Ensure pilot needs are appropriately documented in BRD/TRD and author documents when necessary.
Ensure designs are cost effective and scalable
Partner with IT and other Horizon departments to develop capabilities required to support the pilots
Create and revise and maintain workflows/work instructions to support pilot operations
Develop training materials and ensuring the training is administered to necessary population; coordinate training and communication activities as required to assure successful transition of project deliverables to ongoing operations
Monitor coding and configuration of systems to ensure capabilities are delivered accurately and timely.
Participate in User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements; creates and executes UAT cases.
Develop and maintain pilot operations manuals
Participates in the complete system development life cycle
Partner with appropriate HHI and Horizon resources to respond to issues by analyzing the request, establishing a resolution and where possible, implementing a procedure to eliminate future issues of the same nature.
Act as SME for HHI specific applications in specified domain area to track and monitor application performance relative to pilot objectives
Provide ongoing support and maintenance to ensure new processes and other capabilities meet SLA  and pilot objectives.  Assess opportunities and develop recommendations to enhance pilot operations.
Education:
 
Bachelor's Degree strongly preferred (equivalent work experience may be considered)
Graduate studies and/or professional development activities a plus
Experience:
 
Minimum of 5-7 years of related IT work or business process (analysis) required; preferably in the health insurance industry
Demonstrated experience in a key contributor role in company initiatives
Demonstrated track record of roles with increasing responsibilities
Consulting experience preferred
Programming experience a plus
Strong ability to apply structure to loosely defined medium to complex problems required
Demonstrates understanding of core business functions and systems
Business process analysis and documentation
Business and systems claims processing knowledge, preferred
Understanding of IT processes, tools, cost and effort estimation, delivery cycles
Knowledge of business and technical requirements gathering and documentation
Requires knowledge of system development life cycle and implementation methodologies, required
Strong Microsoft Office Suite knowledge, required
Requires the ability to interface with internal and external customers along with strong ability to influence, gain commitment and follow up
Requires skillful project execution experience and knowledge
Demonstrated ability in negotiation and conflict resolution.
Requires ability to multitask and handle multiple projects simultaneously
Strong customer focus, adaptability and passion for learning and initiating action.
Demonstrated ability to work in a matrix environment
 
Requirements: 
Education  Bachelors 
Job Level  Individual Contributor 
Expertise  Information Technology 
Job Type  Full Time 
Location  Newark, NJ, -- Penn Plaza 

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