Specific Skillset Requirements: We are seeking a seasoned Business Analyst with expertise in Optum Claims Editing System (CES) with integration experience with Facets and Epic Tapestry. This individual will be responsible for driving CES configuration, edit implementation, and system alignments. The role demands cross-functional collaboration, system analysis, and execution oversight to enhance claims adjudication workflows and ensure alignment with payer strategies, Optum CES and Facets experience.
Expenses allowed: TBD
Corewell Health Equipment to be Provided
Job Summary:
Under minimal supervision, formulates and defines systems scope and objectives through research and fact-finding, combined with an understanding of applicable business systems and industry requirements. With this knowledge, develops or modifies moderately-sized information systems. Includes analysis of business and user needs, documenting requirements, and revising existing system logic issues as necessary. Considers the business implications of the application of technology to the current business environment. Assists and advises less-experienced Business Systems Analysts. Competent to work in some phases of systems analysis, but may require guidance in others.
Essential Functions:
- Under minimal supervision, with the implications of the application of new/differing technology to the current business environment in mind, utilizes research and analysis, along with an understanding of relevant business systems and industry requirements, to define systems scopes and objectives for developing new, or improving existing, information systems.
- Performs business analysis, workflow analysis and optimization, works with users to define their needs and then document requirements.
- Collaborates with others to troubleshoot issues with existing systems.
- Remains current with business requirements and needs, based upon future industry trends and changes and understands the implications for existing technology.
Must Have
Nice To Have
Qualifications:
- Required Associate's Degree Technical school or equivalent
- Preferred Bachelor's Degree or equivalent
- 2 years of relevant experience in the field Required
- 3 years of relevant experience in the field Preferred
- Experience formulating and defining systems scopes and objectives Preferred
- Experience in systems development lifecycle, including requirements gathering and design Preferred
- Participant in multiple phases of an integrated system implementation Preferred
- Background in a health care, sciences or information systems Preferred
Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.
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Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.
Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.
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