Business Analyst, Senior
Blue Shield of CaliforniaAbout the role
Your Role
The Installation and Billing department ensure accurate and timely member eligibility and premium billing. The Business Planning and Risk Management team enables goal setting and corporate strategy alignment, budget, forecasting, staffing, and performance monitoring to enable department success. Additionally, they enable quality assurance; drive adherence to standards, regulations and internal policies; mitigate risks and optimize operational efficiency to support organizational goals of compliance and audit readiness. The Business Analyst Senior will report to the Senior Manager, Program & Project management. In this role you will lead and manage Small Business and Individual Family Plan (IFP) compliance guidelines in consultation with Legal, Product, Sales, I&B, and other stakeholders.
Your Work
In this role, you will:
- Provide complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
- Develop annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)
- Develop, prepare, and analyze reports with complex analysis and data for management review, and present to various levels of management
- Define business requirements and provide analysis to increase operational efficiency
- Provide analytical support for multiple, complex cross-functional projects simultaneously; establish work plans and timelines
- Manage Small Business and IFP compliance guidelines in consultation with Legal, Product, Sales, I&B, and other stakeholders
- Create training materials and conduct trainings
- Actively participate in Small Business enrollment forms revision processes to improve workflows/processes and customer experience, implement mandates and business rule changes, facilitate automated enrollment, ensure compliance with regulations and business rules, and deter fraud and abuse
- Identify & assist in the implementation of process improvements and automated enrollment business rule logic
- Analyze, research, and consult with appropriate resources to provide guidance on compliance issues and questions and ensure policies, procedures, and communications meet state, federal, and business requirements. Proactively identify and mitigate potential risks that could impact quality or compliance to ensure audit readiness
Your Knowledge and Experience
- Requires a bachelor’s degree or equivalent experience
- Requires at least 5 years of prior relevant experience
- Proficiency in Word, PowerPoint, and Excel desired
- Experience in IFP and Small Group desired
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