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MANAGER BEHAVIORAL CARE INFORMATICS

YONKERS, NY, US


The Systems Business Analyst is part of our development team maintaining and enhancing Billing and Claims Data Interfaces, Financial web application and Billing portion of the care management web portal. 

He or she has extensive responsibilities such as:

  • Documents existing system components using Visio and MS word.
  • Elicits business requirements and works with the business areas on establishing rules for Care Management and Billing systems; conducts Workflow and Gap Analysis.
  • Using his/her expertise in Data Interfaces, serves as the subject-matter expert in the daily data interface between our system and a centralized NYS system.  Supports NYS system releases, understands the impact of the specification changes and maps them to the changes needed in our system.  Troubleshoots issues in the data interface as they arise, defines and tests corresponding system changes. Establishes monitoring and validation procedures.
  • Using his/her expertise in X12 format, establishes mapping for our outgoing and incoming eligibility and claims transactions into X12.
  • Creates functional specifications (BRD/FRD) for Web and SQL developers including process flow and data flow diagrams.
  • Creates intelligent prototypes of user interfaces for web developers using Axure RP.
  • Analyses designs for compliance with HIPAA and Medicaid standards and identifies gaps
  • Presents proposed solutions to business teams.
  • Works with the development team to ensure correct implementation, reports status to management.  Plans and conducts QA and regression testing of software products; Facilitates User Acceptance testing.
  • Designs and monitors discrepancy reports and continuously analyzes transaction data using SQL.
  • Troubleshoots issues; collaborates with technical and business teams on implementing and scheduling system patches.

Required Skills:

  • Strong understanding and practical experience with billing and accounting processes including Health Care claims, Account Payable and Receivable and various accounting transactions
  • Working knowledge of X12 EDI.  Familiarity with the X12 EDI structure for Healthcare Claims submission (837/835) and Eligibility (270/271).
  • Strong understanding and practical experience with data interfaces using multiple file specifications
  • Working knowledge of SQL and understanding of relational data models
  • Strong SQL Data analysis skills, ability to extract and aggregate data for production support and reporting from SQL Server Databases.
  • Strong analytical ability and experience with independently eliciting requirements and performing gap analysis and writing BRDs or Use Cases.
  • Client relationship management experience including working with customers on multiple concurrent deliverables
  • Strong communication skills, ability to effectively communicate with business as well as development teams
  • Presentation skills, experience presenting to technical and non-technical audiences
  • Strong understanding of QA/UAT testing processes and practical experience with writing and executing test plans
  • Proficiency in MS Word, MS Excel, MS Visio, MS Power Point, MS Project, UML, SQL Server
  • Proficiency in at least one prototyping tool (Axure RP preferred)

 

Soft Skills:

    • Team player
    • Comfortable with complex processes with many moving parts
    • Comfortable with time-sensitive tasks which have financial implications if not completed on time
    • Demonstrates ownership and sense of urgency

 

Education Requirements: B.S. in CS, Info Tech, Physics, Math or Engineering

Minimum Experience: B.S. and 5 years or M.S. and 3 years

 

 

Department: CMO Bargaining Unit: Non Union Campus: YONKERS  Employment Status: Regular Full-Time Address: 100 Corporate Blvd, Yonkers
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 145208 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

#LI-AA1; N/A 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity

 

 

 


Nearest Major Market: Yonkers
Nearest Secondary Market: New York City