Senior Business Systems Analyst - Health Plan

 
Position: Senior Business Systems Analyst - Health Plan

Job ID: 157648

Location: US-TX-Bellaire

Department: TCHP IS SUPPORT

Talent Area: Information Services

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8 AM to 5 PM

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 Created 1.2020 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Senior Business Systems Analyst -- someone who works well in a fast-paced setting. In this position, you will coordinate all phases of a system optimization or upgrade project and provide production services such as recommending improvements to strategy, system usage, or process through the application of business and technology skill sets. This role reviews and analyzes systems including testing and documenting for all applications. You will represent the business/clinical interests and needs of a given project and/or specific component within a project and consult with stakeholders to identify current operation procedures and to clarify program objectives. This role will also entail the following:

  • Strong business analysis skills and ability to translate business processes to technical application data interface requirements
  • Direct experience in data analysis and strong skills in data analysis tools; particularly MS SQL
  • Experience with Medicaid regulatory requirements governing claims processing and claims encounters
  • Experience with health plan data integration, specifically HIPAA X12 transactions for claims and Medicaid claims encounters submitted to the State,  (837I and 837P)

 

Think you’ve got what it takes?



Responsibilities :

  • Collaborates with stakeholders to identify system issues, business process needs, and other integrating systems are being optimized effectively
  • Supports business/clinical operations and serves as liaison to I.S. supporting continued system maintenance and optimization
  • Coordinates the development of test scenarios and test scripts for integration and user acceptance testing in coordination with Information Services support and project teams
  • Works with I.S. and customers to perform functional configuration analysis for system implementations, on-going maintenance, and other projects
  • Analyzes business use of existing systems to identify problem to be resolved and defines system applications or process improvements
  • Develops and maintains training materials and training environment for systems training
  • May travel to practice sites, including but may not be limited to travel within Houston and Austin


Qualifications:

  • High school diploma or GED required
  • Bachelor’s degree in business administration, healthcare administration, or other related field preferred
  • 11 years’ experience in healthcare operations and/or information systems implementation
  • A bachelor’s degree will substitute for 4 years of experience
  • Strong preference for Medicaid and State Regulatory experience


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