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Job Summary
The Business Analyst III (BA III) acts as the primary liaison between IT and the operational departments within
the organization. This position functions in a trusted advisor role. The BA III provides subject matter expertise
to the clients in which it serves through analysis and the development of business and functional requirements
for initiatives of all sizes. The Business Analyst III serves in a relationship management role to increase
customer service, and participates on project teams to assist in the scoping and timely delivery of IT projects.
This role also serves as a mentor to team members.
This position will primarily support the Medicare Program within the Fidelis organization including but not
limited to IT request management and assignment, day-to-day support activities, production issue management
and resolution, maintenance, discretionary and strategic initiatives, and annual recurring projects such as CMS
Audits, Data Validation Audit, Medicare Risk Medical Records sweep, Annual Medicare Benefits changes and
CMS Open Enrollment enhancements including reporting, ANOC, EOC, and Low Income Subsidy Acumen
Match Rate reporting.
Responsibilities
Serves as technical and subject matter expert for initiatives involving the Medicare line of business.
Leads and guides workgroups through the evaluation of current state processes. Performs analysis to
define opportunities to create improved future state workflows/solutions (end-to-end process flow
development)
Assists management and end users in evaluating vendor software applications.
Leads and facilitates requirements and design sessions. Documents business and functional specifications
used for software design and development including software traceability matrices and use case diagrams.
Conducts requirements reviews to obtain sign-off from project/operational stakeholders.
Sets projects timelines with identified deliverables. Creates task lists/project plans for smaller initiatives.
On larger project initiatives completes assignments as defined by the Project Team.
Reports project status updates to stakeholders
Identifies issues and facilitates problem resolution for manual, batch and online environments. Ability to
interrogate error codes
Uses metrics and data to lead process improvement initiatives
Analyzes and queries data; has knowledge of the Facets data models
Data mapping, including the creation of file specifications; source to target mapping
Testing, including the creation of test scenarios, test data and understanding of outcomes
Mentors customers and peers
Communicates internally and externally with all levels of employees including senior management
Interacts with all areas of Information Technology as well as software vendors
End-to-end ownership of assigned initiatives – requirements through implementation
Keeps current with industry trends and state/federal compliance initiatives
Participates in user groups
Qualifications
BA/BS - Bachelors Degree or equivalent required. Degree in Computer Science or Computer
Programming a plus
Minimum 5-8 years previous experience as a Business/Systems Analyst
Health Care Industry experience
Knowledge of health care benefits and product offerings including Medicare, Dual, FIDA and SNP
programs
Previous experience with TriZetto Facets applications preferred including EAM – Enrollment
Administration Manager.
Proficiency with SQL (querying, analyzing and mapping data)
Demonstrated ability to ..
o Lead and elicit business needs and requirements from a diverse set of stakeholders
o Document and communicate requirements to the stakeholders, developers and testers.
o Construct or modify use case diagrams and process models.
o Create and execute test scenarios
Experienced in full software development life cycle
Understanding of the concept of online and batch environments
Excellent PC skills utilizing Microsoft Office software (Excel, Word, Visio, PowerPoint, and Access)
Proven problem solving and analytical skills
Detail oriented with the ability to manage multiple tasks simultaneously
Excellent organization and follow through skills
Excellent interpersonal, written and verbal communication skills
Ability to build and maintain good rapport with internal and external customers and handle situations with
confidence, tact and resourcefulness
Flexible, adaptable with the ability to work under pressure to meet deadlines in a fast paced environment
Strong team player