Healthcare IT Business/EDI System Analyst Lead

Job Description

Posted Monday, October 7, 2024 at 5:00 AM

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

We are seeking a full-time, remote senior or lead for this position. The IT Business Systems Analyst (SBA) Lead is instrumental in leading the BA team and assigned resources to the effort in successful delivery of the initiative. The position holds accountability for leading and facilitating requirements elicitation sessions among business and technical users, writing business and technical requirements and specifications, providing functional/conceptual/logical design documents, and building applicable business case models. This position will exemplify the abilities to engage and clearly discuss requirements and specifications with the full spectrum of integrated roles from business users and developers to integration with the QA and UAT team to ensure comprehensive test plans are executed and traceable to individual user stories.

This includes gathering and analyzing data in support of business cases, proposed projects, and systems requirements. The position is also responsible for generating and analyzing data/reports based on their findings, complete with probable causes and possible solutions to systems issues.

Working with the Project Manager(s) to follow project plans, convey accurate project status, and identify issues and risks. Responsible for providing level of effort and durations for completing tasks required for given project. May be assigned to coordinate projects from development through implementation, working with the organization’s IT team, as well as clients, vendors, and consultants.

RESPONSIBILITIES:

• EDI experience preferred.
• Determines and documents customer business requirements through formal Business Analysis processes. This task involves planning, designing, and developing efficient business and operations systems in support of core organizational functions and business processes. This individual will apply proven communication, analytical, and problem-solving skills to help maximize the benefit of IT system investments.
• Comprehensively documents business requirements within functional and technical specifications by writing detailed description of user needs, program functions, and steps required to develop or modify computer program. Analyze and reviews existing computer system capabilities, workflow, and scheduling limitations to determine if requested program or program change is possible within existing system. Studies existing information processing systems to evaluate effectiveness and develops new systems to improve production or workflow as required.
• Helps evaluate the impact of corporate initiatives, goals, and vision upon existing application modules; recommends ways to improve or best utilize corporate information to support actualization of corporate objectives based from understanding of current business process.
• Analyzes user requirements, procedures, and problems to automate processing or to improve existing computer system. Confers with personnel of organizational units involved to analyze current operational procedures, identify problems, and learn specific input and output requirements, such as forms of data input, how data is to be summarized, and formats for reports.
• Provides functional/conceptual/logical design documents/data models, building applicable business case models, preparing and/or implementing UAT scenarios and facilitate UAT testing as documentation of program development.
• Ensures continuous user involvement in the analysis, development, and implementation process of new applications, enhancements, fixes through organization of cross-functional meetings and working with the Project Manager to follow project plans, convey accurate project status, and identify issues and risks. Acquires end user sign off of scope requirements. Files documented results of analysis with project documentation.
• Supports the operations and finance systems, including implementation, troubleshooting, maintenance, and support of existing applications. Assists developers to prepare complex datasets or reports which require advanced query or complex business process.
• Creates and maintains documentation on the system/applications used by the department. Provide inputs in development of conversion and software implementation project plans on assigned projects. Works with developer to coordinate completion of systems change control requests and schedules for movement of application across regions (Development to Acceptance to Production). Obtains (or works with PM as assigned) approvals of project documentation and implementation plan and files with project documentation.
• Coordinates projects from development through implementation, working with their organization’s IT workers, as well as clients, vendors, and consultants.
• Assists managers by providing solutions input in response to the operational and strategic needs including research, investigation and making recommendations on new solutions or replacement systems/applications.
• Directs or assists in the development of new or revised training materials, and training schedule. Assures all affected functional areas are included and informed. Trains or assists in the training of ITS and user personnel in the conversion, implementation or providing overview of the developed or purchased software.
• Assists the software developers in resolution of work problems related to flow charts, project specifications, or programming. May provide assistance to UI development where rules, formatting, and display properties can be set in the design time using existing development tools.
• Works with the DBA to provide business analysis on troubleshooting of data-related production issues, as well as tests and deploys approved solutions in accordance with existing release management process.
• May work with end users and other ITS personnel to evaluate packaged software. May represent Paradigm at vendor focus or user group meetings. May serve as contact point for technical issues between vendor and Paradigm or with business users within the company.
• Mentors less experienced BA’s, reviews work and provides guidance.

QUALIFICATIONS:

• Education - College degree, preferably a B.S. in Information Systems, Computer Science, or a degree with Clinical focus from an accredited college or university or equivalent experience in programming in a distributed computing environment or clinical/healthcare experience.
• Experience - 10 or more years of work experience in business or systems analysis within the IT development field, with three (3) of those years in the healthcare industry; OR any combination of academic education, professional training, or work experience which demonstrates the ability to perform the duties of the position.
• Workers’ Compensation or Healthcare experience including knowledge of provider coding, billing, contracting, and claims administration practices.
• Required non-technical proficiencies and knowledge:
• Critical skills include excellent interviewing, facilitation, organization, project management, analytical and problem solving, mentoring and strong verbal communications and documentation writing abilities.
• Strong customer service skills and prior experience supporting internal customers.
• Good presentation skills and the ability to provide end-user training.
• Ability to make judgments, decisions, and suggestions for procedural improvements.
• Ability to handle fast-paced workflow and multi-task.
• Flexible to meet changing needs and multiple tasks.
• Excellent follow-through skills with strong attention to detail.
• Strong ability to develop, understand and translate detailed requirements documentation from business client requirements.
• Adaptive and open to frequent changes in work environment and prioritization.
• Able to manage multiple competing deadlines.
• Efficiently able to work independently and as part of a team.
• Required technical proficiencies/knowledge:
• Familiar with advanced IT concepts, IT policies, service-oriented architecture, and web services.
• Good SQL skills set and data analysis skills.
• Thorough understanding of the Software Development Life Cycle, change management, and SCRUM/Agile processes.
• Good knowledge of Word, Excel, Visio, and PowerPoint.
• Familiarity with JSON and XML.
• Enhanced knowledge of software quality assurance methodology and practice.
• Understanding of systems and applications with the ability to learn managed healthcare systems, analyze data, and solve problems.
• Preferred knowledge of EDI X12 transactions like 837, 835, 276/277, 997/999. Working knowledge of EDI translation software packages. Good understanding of EDI transaction sets, data mapping, and organization.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.