Business Systems Analyst Carrier Integration

The mission of Washington Health Benefit Exchange (Exchange) is to radically improve how Washington residents secure health insurance through innovative and practical solutions, an easy-to-use customer experience, our values of integrity, respect, equity and transparency, and by providing undeniable value to the health care community.

The Exchange is a public-private partnership that operates Washington Healthplanfinder, the eligibility and enrollment portal used by one in four Washington residents to obtain health and dental coverage. Through this platform, and with support from a Customer Support Center and statewide network of in-person navigators and brokers, individuals and families can shop, compare and enroll in private, qualified health plans (as defined in the Affordable Care Act) or enroll in Washington Apple Health, the state Medicaid program.

The Exchange embraces the following equity statement adopted by our Board of Directors:

Equity is fundamental to the mission of the Washington Health Benefit Exchange. The process of advancing toward equity and becoming anti-racist is disruptive and demands vigilance to dismantle deeply entrenched systems of privilege and oppression. While systemic racism is a root cause of many societal inequities, we must also use an intersectional approach to address all forms of bias and oppression, which interact with and often exacerbate racial inequities. To be successful, we must recognize the socioeconomic drivers of health and focus on people and places where needs are greatest. As we listen to community, we must hold ourselves accountable to responding to recommendations to remedy inequitable policies, systems, or practices within the Exchange’s area of influence. Our goal is that all Washingtonians have full and equal access to opportunities, power and resources to achieve their full potential.

SUMMARY

The Business Systems Analyst (BSA) - Carrier Integration position is responsible for driving resolution of identified issues and supporting business solutions for the products and programs at the Washington Health Benefit Exchange, specifically as they relate to the integration of enrollment activities between participating carrier systems. The Business Systems Analyst is a member of the Carrier Operations Team and is matrixed to work closely with other internal teams, vendors and insurance carriers to analyze and resolve issues and identify new solutions and processes. The Business Systems Analyst is expected to maximize current and new technology capabilities relevant to enrollment functional areas within Washington Healthplanfinder systems to develop solutions to improve business processes, support workflow and improve efficiencies.

This position may serve as a cross-functional Functional Analyst on a Scrum team or Shared Service Team responsible for reviewing system issues and design changes. This shall include the intake, triage, and the analysis processes associated with system issue management.

***Please be aware: A cover letter is a required component***

DUTIES AND RESPONSIBILITIES

Issue Analysis

• Perform triage, analysis, and quality assurance on work order requests and other incidents submitted through system issue processes, with specific focus on EDI/Enrollment transaction concerns.

• Document system issues, actual and expected results, impacted populations, and relevant business rules.

• Support carrier vendor and other technical transitions that impact work with WAHBE

• Identify impacted populations by leveraging various data sources, including SQL database.

• Coordinate data correction associated with system issues, assuring best practices are followed.

• Identify areas for improvement and add relevant details into system Requests for Change (RFC) or related business processes.

• Communicate with stakeholders regarding product issues and coordinate follow-up actions.

• Support business and IT to refine operating processes and procedures to deliver solutions and services more efficiently.

• Undertake post incident reviews and produce associated documentation and tasks.

• Maintain a comprehensive understanding of all aspects of product delivery processes and operations.

• Escalate to appropriate staff when urgent problems are identified.

Functional Analysis

• Serve as technical subject matter expert for enrollment transactions (834 and 820), Full Carrier Audit, Provider Directory, and other related system areas. Provide functional and technical expertise to delivery teams and internal and external stakeholders when needed.

• Support FitGap (carrier accountability) analysis of functional system requirements and processes, for both internal and integrated systems. Work with business teams and delivery teams to ensure technical support needs for carriers are identified and supported.

• Support development and distribution of user guides, training materials, and reference materials as it relates to EDI, enrollment, and carrier integration to ensure stakeholders are informed.

• Serve as cross-functional team player who will step in, as needed, for testing, requirements gathering, or other functions to support integration of enrollment data between Carrier and Exchange systems.

• Work with the delivery teams to develop solution requirements (epics, user stories, acceptance criteria, automation test items, and other supporting documentation) to address objectives for Requests for Change (RFCs).

• Support and assist with the planning and execution of interface and data conversion design, development, testing and implementation.

• Support EDI and Enrollment Product Owners in maintaining and understanding the delivery teams’ backlogs, providing context related to enrollment and Carrier concerns.

• Support delivery teams in developing and reviewing design documentation to ensure it is current, accurate, and maintained.

• Actively participates in change management activities.

• Ensure compliance with System Development Life Cycle (SDLC) as it relates to issue analysis/escalation and submission of Requests for Change (RFCs).

Other duties

• As assigned.

QUALIFICATIONS

Required:

• Bachelor’s degree in information technology, business or another related field.

Note: Systems analysis experience can substitute for education, year for year. One of the following certifications may substitute for education requirements: PMI-PBA, PMP, CBAP

• Three years of business analysis or IT system analysis experience.

Note: Work experience proving functional knowledge of Washington Healthplanfinder may replace analysis experience, year for year.

• Strong analytical skills with experience that includes: root cause analysis, business case development, gap analysis, process mapping, requirements management, design documentation.

• Prior experience working with EDI files.

• Ability to learn new systems and business processes while working with ambiguity and rapid change in a fast-paced environment.

• Ability to refine business and system needs into clear and concise requirements that can easily be understood by technical and non-technical groups.

• Stakeholder analysis skills.

• Ability to work with remote development teams.

• Experience with systems testing, to include developing and executing test cases.

• Strong debugging and problem-solving skills.

• Good working knowledge of Microsoft Office programs.

• Excellent verbal and written communication skills.

• Ability to successfully translate technical information to non-technical audiences.

• High degree of organizational skills.

• Self-motivated, highly adaptable, and positive team player with a can-do attitude.

Desired:

• Certification related to business analysis or project management such as PMI-PBA, PMP, or the CBAP.

• Functional knowledge of Washington Healthplanfinder and/or integrated systems.

• Prior experience working with ASC X12 TR3 5010 834, 820 file types.

• Prior experience using Agile methodology for software development.

• Ability to review and write queries using Structural Query Language (SQL).

• Working knowledge of XML.

• Working knowledge of JIRA and Confluence.

APPLICATION INSTRUCTIONS

This position will be open until we find a suitable number of candidates to review. If interested, please submit an application with a cover letter as soon as possible. The Exchange reserves the right to close the recruitment at any time.

***Please be aware: A cover letter is a required component***

SALARY INFORMATION

The hiring salary range is between minimum of $72,475.00 and the midpoint of $78,777.00 depending on candidate experience, internal equity, and the market. Our compensation policy reserves the salary range above the midpoint for meeting and exceeding expectations and growth and development, up to the maximum of $94,532.00.

BENEFITS

Take a peek at our benefits package.

WORKING CONDITIONS

Core business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. There are times where irregular hours will be required. The preferred duty station is our Olympia, Washington headquarters. The nature of this role relies heavily on remote and in-person collaboration. While a hybrid remote and on-site schedule may be considered, the position will require flexibility to allow for in-office availability as business needs dictate. Travel requirements will be limited, however there may be occasions where an employee is required to travel and work irregular hours to attend meetings or trainings. Duties of this position require the use of standard office furniture and equipment, including setup for remote work. The employee is responsible for providing and maintaining a safe, ergonomic, and secure workspace at their remote location.

The working conditions and physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SPECIAL REQUIREMENTS

A criminal background screen will be conducted for candidates under final consideration, and if hired, every five years of employment where highly sensitive data is processed or maintained by the position. The result of this background screen must meet the Exchange’s eligibility standards.

OTHER INFORMATION

The above statements are intended to describe the general nature and levels of work being performed. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills of personnel so classified.

This is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

The Washington Health Benefit Exchange is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We participate in E-Verify. You can view the Department of Justice's Right to Work poster here.