Business Analyst

BUSINESS ANALYST NEEDED IN  LAKE OSWEGO, OR - WE WANT TO TALK TO YOU!

As a global business and technology consulting services leader, Enclipse focuses on delivering tangible solutions. 

By employing a team committed to questioning and challenging the status quo, Enclipse has established a culture that encourages independent thought, innovation, and flexibility.

If you join Enclipse, you can expand your technology platform while working for the Nation's most dynamic Health Care Leader.

WE PROVIDE:

Class A Benefits  that Start ASAP
The Personal Touch -- You deserve it, We deliver it!

Contract Terms: W2

Lake Oswego, OR 97035

7 + Months

POSITION:

We are seeking a seasoned, self-motivated and results-driven IT Professional who can make it happen no matter what challenges are encountered along the way. An outside the box thinker who will always find creative ways to lead the solution design work on complex IT Projects in the EDI & Claims domain.

The EDI & Classic Claims Solution Design group is responsible for driving and completing the analysis and logical design work on all IT Projects, which impact the EDI and Claims domain. Our portfolio of applications includes both in-house developed and Vendor products, representing a full suite of a highly integrated and complex EDI and Claims environment, spanning multiple technologies and platforms.

The Solution Consultants study the overall business and information needs of an organization, in order to develop solutions to business and related technology problems. This includes consulting with Business Partners to define requirements and develop solution alternatives and estimates (Business Engagement Consultants) and translating client's business requirements into specific systems, applications or process designs for large complex IT solutions and integrating architecture (Solution Consultants) and assuring the integration of corporate business application architectures.

BASIC QUALIFICATIONS - MUST HAVE

8+ years of experience in a senior solutions design role in Health Plan Managed Care environment
Recent 2-3 years experience in Health Plan Claims and EDI Solution Analysis and Design
Prior consulting experience with an emphasis on delivery of complex enterprise solutions
Experience using structured software life cycle SDLC, Agile
UML modelling knowledge and hands-on experience; sequence diagrams, class diagrams etc.
Experience in conducting vendor assessment and evaluating software packages and working with application vendors and system integrators on Request for Information/Request for Proposals
Knowledge of using Microsoft Project and ability to work with Project Manager to create workplans
Excellent problem-solving and decision-making skills, strong collaboration, documentation and presentation skills along with strong oral and written communication skills are a must.
Analytical, troubleshooting, communication and presentation skills.
Thinks and Acts creatively to come up with solutions that fulfills the project schedule and compliance requirements
Candidate should have experience working in a Matrix team environment with strong customer relationship management and customer service skills.
BS in CS or related field
BS in CS or related field

PREFERRED QUALIFICATIONS:

Knowledge of HIPAA Standards and CAQH CORE Operating Rules
MBA or MS a plus

JOB RESPONSIBILITIES:

Lead business and technical analysis efforts
Independently Plan and Execute JAR/JAD sessions following a pre-defined structured and methodical approach
Responsible for understanding current systems & their functional capabilities.
Conduct business requirement and gap analysis sessions
Develop use cases, and user requirement specification documents.
Identify and evaluate solution alternatives
Develop high level technical designs
Liaise with developers, business analysts, and user representatives in application design reviews.
Work closely with Project Manager to create and maintain the workplan

PROJECT INFORMATION:

Part C EOB: A CMS regulatory requirement mandating that all Medicare Advantage Organization produce monthly Explanation of Benefits (EOBs) to the plan enrollees
Administrative Simplification HCR: A regulatory project to implement CAQH Operating Rules
Other - TBD
Can the contractor work remotely or do they need to be onsite.
Onsite with possibility to work remotely 2-3 days dependent on performance which will be assessed after 4 weeks from onboarding