Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.  

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”    

The Analyst functions to provide analytical, technical and problem resolution support to Claims, Customer Service and Account Administration. Conducts or participates in activities related to planning, controlling and projects. The analyst must use knowledge of existing business practices, systems, procedures, policies, current testing tools/practices and their interrelationships to provide and ensure innovative approaches and solutions to business problems and requirements in the supported systems. The analyst is responsible for obtaining necessary approvals on systems configuration, systems testing and application changes.

• Demonstrate working knowledge of targeted system applications and tasks. Possess technical knowledge that includes an understanding of Facets tables, with the ability to create and run simple queries. Includes all previous grade level expectations.
• Serve as a department project lead for department/corporate projects and/or maintenance activities as assigned. Communicate project team status updates verbally and in writing to all team members. Identify projects risks and contingencies. Conduct root cause analysis and identify process improvement opportunities.
• Elicit and document detailed business requirements to support maintenance activities and projects.
• Anticipate problems before they occur, document options for solutions, seek necessary approvals, and work with business areas to implement solutions. Generate and consider options for actions to achieve a long-range goal or vision.
• Proficiently and consistently support four (4) or more subject matters, serving as a subject matter expert (SME).
• Mentor less experienced staff in an informal setting. Act as a “coach” to staff learning department functions. Respond to questions from internal and external customers. Document processes and procedures.
• Build strong working relationships with internal and external customers. Summarize verbally and in writing advanced analytical research that is understandable to the intended audience. Facilitate meetings including preparing agendas, minutes, and other documentation as needed. Communicate delays, risks, and impacts to both management and business areas.
• Perform application testing for maintenance and projects. Execute test scenarios and evaluate defects for negative business impacts and document defects.

Skills:

• Ability to analyze problems and issues, determine impact, and develop business solutions for system changes. Ability to act as a liaison and recommend solutions to a variety of departments, as well as other Plans and other external business partners.
• Ability to plan, organize, lead and control projects.
• Ability to effectively communicate in writing and verbally with technical and non-technical audiences. Also includes persuasion and negotiation skills to resolve differences with skill and understanding.
• Ability to quantify and prioritize assigned activities, the ability to adapt to changing priorities, and perform duties with minimal supervision. Includes ability to act both independently and as part of a team.

Knowledge:

• Knowledge of the health care industry and/or Capital Blue Cross corporate structure. Includes knowledge of standards, policies, and business practices and procedures for multiple operational areas/systems. Is familiar with those business services, systems and/or processes provided by external business partners.
• Knowledge of data processing terminology and concepts. Includes a high-level technical understanding of technologies such as Microsoft Office Suite, Crystal Reporting and Data Modeling
• Proficiently conducts cost benefit analysis techniques.
• Ability to lead meetings and give presentations to both management and staff. Includes the ability to develop teamwork among diverse groups.

Experience:

• Experience working with integrated business systems that handle claims processing, membership, billing, network, clinical, customer service, and product processes.
• Prefer familiarity or experience with any of the peripheral systems to Facets.
• Preferred proficient knowledge and experience with reporting capabilities.

Education and Certifications:

• Prefer a bachelor’s degree in one of the following: business administration, health planning and administration, information systems, computer science; and 3-5 years’ relative experience.

Work Environment:

• Working environment includes typical office conditions.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week.
• The employee must occasionally lift and/or move up to 5 pounds.
• Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions.
• Work requires visual acuity to perform close inspection of written and computer-generated documents as well as a PC monitor. Working environment includes typical office conditions.

Other:

• Ability to communicate effectively with all levels of personnel, both internal and external.
• Travel may be required and could potentially include overnight excursions.

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.