Job details
Job type full-time
Full job description
Blue cross blue shield of arizona is a local, independent blue cross blue shield association and a not-for-profit health insurance company headquartered in phoenixFounded in 1939, the company has more than 1,800 dedicated employees throughout its phoenix, tucson, chandler and flagstaff officesProviding health insurance products, services and networks to more than 1 million arizonans, blue cross blue shield of arizona offers various health plans for individuals, families, and small and large businessesBlue cross blue shield of arizona also offers medicare supplement plans to individuals over age 65.
Blue cross blue shield of arizona helps to fulfill its mission of improving the quality of life of arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Job title
Pricing configuration analyst
Job code(s)
235045 (lev 1) (235046 lev 2; (235047 lev 3; 224045 lev 4)
Salary plan
Tech
Grade(s)
23 – 31
Department(s)
Information technology
Flsa status
Exempt nonexempt
Job level definitions
Level 1 pricing conf analyst i (grade 23 – 24)
Level 2 pricing conf analyst ii (grade 25 – 27)
Level 3 pricing conf analyst iii (grade 28 – 30) level 4 pricing conf analyst– lead (grade 31)
Purpose of the job
Updates system configuration for the automated pricing functionalityDesigns and develops pricing applications to support current operating systemPerforms analysis and ensures accuracy of pricing design and implementation.
Qualifications
Required qualifications
Required work experience
1 year of experience with business requirement design and/or bcbsaz production systems (level 1)
3 years of experience in computer technology and/or information systems (levels 2 – 5)
3 years of experience in data management and reporting (levels 2 – 5)
3 years of experience working in healthcare-related systems as a systems analyst or programmer (levels 3 – 4)
Required education
High-school diploma or ged in general field of study (all levels)
Required licenses
N/a
Required certifications
N/a
Preferred qualifications
Preferred work experience
5 years of experience in computer technology and/or information systems (all levels)
7 years of experience in data management and reporting (all levels)
5 years of experience working in healthcare-related systems as a business analyst or programmer (all levels)
3 years of experience with qnxt configuration
3 years of qnxt provider and enrollment maintenance
3 years of experience with interpreting provider contracts, terms and fee schedules for provider configuration and maintenance
1 year experience with qnxt payment processing procedures
Preferred education
Bachelor’s degree in computer science, information systems, business, or related field (all levels)
Preferred licenses
N/a
Preferred certifications
N/a
Essential job functions and responsibilities
Level 1 – entry-level role; performs job functions under close supervision or peer review
Research, analyze, track and resolve basic issues with claims, configuration, and pricing
Develop business objectives, processing requirements, and specifications
Perform basic configuration
Develop basic test plans and scripts
Perform basic data corrections
Research and analyze procedural problems and provide recommendations for improvements and changes.
Develop functional specifications, logic flows and other documentation as applicable
Write or modify procedures for internal use, user operational areas and system use.
Translate business needs into technical solutions
Participate on small to medium scoped projects
Level 2 - performs job functions with general supervision and peer review
Research, analyze, track and resolve moderately complex system problems
Perform basic to moderately complex configuration
Build, support, and maintain basic to intermediate processes, programs, and data
Provide annual coding update changes and upload fee schedules
Participate or lead small to medium scoped projects
Draft programs, time estimates and project schedules based on prioritization and business requirements
Create basic ad-hoc reports for internal and external use
Test system changes
Level 3 - performs job functions with minimal supervision
Provide peer-level review and mentoring to levels 1 and 2
Participate and/or lead large- or complex-technical projects
Evaluate high-level projects and assess components to forecast work effort; delegate components if appropriate
Facilitate and/or create new procedures and processes that support advancing technologies or capabilities
Research, analyze, track and resolve complex system problems
Perform advanced configuration
Perform advanced data corrections
Build, support, and maintain moderately complex processes, programs, and data
Create complex ad-hoc reports for internal usage and external usage
Write technical specifications for reports and programming changes as well as conversion specifications and new system functionality
Coordinate activity and responds to requests for analysis related to current data structures, input /output and associated entities.
Ensure the department leverages internal tools and applications effectively
Level 4 - performs job functions in a lead capacity
Act as primary operational contact for internal and external customers when needed / in the absence of manager
Ensure service level agreements between department and operational or technical areas are met
Lead, develop and mentor staff by providing opportunities for growth through delegation, training, and assignment to various project teams
Inform manager of any issues impacting the efficient and effective performance of the department including system, resource, and informational barriers; provide timely feedback to team member on performance
Assist the manager in the day-to-day operations of the department
All levels
Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
Stay current on new developments in technology-related industries
Participate in corporate quality programs
The position requires a full-time work scheduleFull-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirementsParticipate in on-call rotation
Perform all other duties as assigned
Competencies
Required competencies
Required job skills (applies to all levels)
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate pc proficiency
Intermediate proficiency in spreadsheet, database, charting, business intelligence and word processing software
Intermediate knowledge of computer operating systems
Basic knowledge of programming, database systems, and data management
Required professional competencies (applies to all levels)
Strong analytical skills to support independent and effective decisions
Ability to prioritize tasks and work with multiple priorities, sometimes under limited time constraints.
Effective interpersonal skills and ability to maintain positive working relationship with others.
Verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.
Systems research and analysisAbility to write and present business intelligence documentation
Ability to interpret medical, legal, and other technical data
Knowledge of business requirements development and user acceptance testing.
Maintain confidentiality and privacy
Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
Required leadership experience and competencies
Facilitate and resolve customer requests and inquiries for all levels of management within the corporation(applies to levels 2 - 4)
Build synergy with a diverse team in an ever changing environment(applies to level 4)
Preferred competencies
Preferred job skills (applies to all levels)
Knowledge of hipaa regulations and provider code sets
Advanced proficiency in spreadsheet, database, flow charting, and word processing software
Advanced knowledge of data mapping techniques
Advanced knowledge of computer operating systems
Advanced knowledge of provider contracting and associated reimbursement methodologies
Strong knowledge of programming, database systems, and data management.
Advanced knowledge of decision support systems
Preferred professional competencies (applies to all levels)
Advanced systems research and analysis expertise
Impeccable project management skills
Solid technical ability and problem solving skills
Knowledge of internal departments and operations
Preferred leadership experience and competencies (applies to level 4)
Ability to provide mentoring and peer review to junior team members
Our commitment
Bcbsaz does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you
Thank you for your interest in blue cross blue shield of arizonaFor more information on our company, see azblue.comIf interested in this position, please apply.
