The purpose of this Business System AOD Principal Analyst role is to directs and participates in the analysis, business technical design, testing and implementation of system enhancements to HealthPartners’ core administrative systems, departmental surround applications, and system control environments. Provides consultative services to system users and stakeholders upon request. Serves as a liaison between internal team members from assigned business operations and IS & T departments, as well as applicable system software vendors. May be assigned project management responsibilities on large and/or complex system projects. Represents HealthPartners’ in local and national industry work groups as assigned by AOD management.

ACCOUNTABILITIES:  

Knowledge Level:

Serves as technical subject matter expert on multiple health plan administrative systems.

Possesses expert knowledge of assigned systems/business operation functions including: system functional capabilities, data interfaces to/from other applications, system outputs, database structures, business processes and procedures, applicable national medical code sets, and relevant federal and state regulatory requirements.

Expert in one or more federal HIPAA health plan transaction standards.

Core Administrative System Fixes/Enhancements

Serve as business systems technical project lead for implementation of large* and/or complex system enhancements/fixes.

Analyze business users’ needs and requirements and lead the planning, design and development of core administrative systems or devise ways to apply existing systems to additional operations or specialized programs

Responsible for the creation of highly detailed business requirements documents for large/complex system fixes/enhancements and required systems control environments. Obtains required business requirements sign-off from business operations and IS & T staff.

Participates in the development and review of IS & T technical systems design recommendations to validate that system functionality is in alignment business requirements.

Assists in the evaluation of potential operational impacts and works with business operations staff in identifying and documenting changes to current business workflows.

Develop systems testing strategy and test plan documents, including identification of required test scenarios and expected results. Review test plan with business operations staff to validate accuracy of test plan.

Conduct required business user system testing and, if needed, review results with business operations and IS & T contacts to obtain final user acceptance testing sign-off.

Work with IS & T and business operations staff to identify implementation tasks and schedule date for system fix/enhancement installation.

Directs and/or participates in the development of user manuals, technical systems documentation, and business operational procedures.

Develop post-implementation strategy and conduct monitoring to validate successful implementation of system fix/enhancement.

 

* Large system fixes/enhancements require greater than 750 hours if IS & T programming time. Changes may affect multiple system applications and business department across the health plan and development/implementation must be coordinated with all affected project constituents.

Project Management

With minimum supervision, serves as project team leader or project manager and directs large or very complex projects as assigned by the Sr. Director and/or Manager, AOD.

Works with the user community and other AOD personnel to develop and achieve project objectives, deliverable schedules, system test and acceptance criteria, and training and education.

Directs programming activity, monitors project schedules and recommends changes as necessary to the project leader.

Verifies compliance to system plans and specifications and reports progress against project schedules.

Provides technical and process guidance and supervision to team members to ensure projects meet all defined requirements and are delivered on schedule.

Report Generation

Analyze business users’ reporting needs and requirements.

Design, program and test required report(s) using appropriate report generation software tool.

Other

Maintains excellent working relationships with internal business customers, IS & T team members, department team members, and project sponsors.

Supports departmental and division team through participation in appropriate meetings and projects.

Serves as HealthPartners’ representative in local and national industry work groups as assigned by AOD management.

Serves as mentor to other departmental business system analysts (both analysts and senior analysts).

Participates in the development and implementation of HealthPartners’ health plan administrative systems strategic systems plan.

Assists Manager and/or Sr. Director of AOD in evaluating prospective employees.

Assists in the development of departmental technical standards and procedures.

May manages service relationships and consults with vendors on systems-related issues & design.

Position requires a high degree of initiative to manage priorities and identify opportunities for systems improvement and innovation. Responsible for continued professional development, including continuing education to ensure their systems and business operations knowledge is current.

Performs other duties and assumes projects as assigned by AOD management team.

REQUIRED QUALIFICATIONS:  

Bachelor's degree in Computer Science, Business Administration, Management Information Systems or equivalent. Applicable previous experience may be considered for this qualification.

Five or more years experience in business systems analysis and/or systems development.

Project management experience as business lead successfully meeting large or very complex project deliverables and timelines on multiple projects. Includes managing a major project (1000+ hours) from initiation through successful implementation and acceptance.

Expertise in CQI, system development methodologies and data object mapping.

Experience and proficiency in/with

multiple health plan administrative systems

interpreting system data models

database applications and end-user software

analytical and reporting tools

Excellent communication skills in technical and non-technical topics.

Excellent analysis and problem solving skills.

 

PREFERRED QUALIFICATIONS:

Fourth generation program language (4GL) experience (i.e. SQL, Crystal Reports, Visual Basic, Business Objects, etc.).

Expertise in multiple health plan administrative operational areas.

Experience using MS Office applications, flowcharting tools, and/or other project management tools.

Two or more years of experience with continuous quality improvement concepts and methodologies.

Experience working with multiple HealthPartners’ health plan administrative systems.

Experience with various electronic processes and systems including external and internal interfaces and systems integration.

DECISION-MAKING:  

Authority to negotiate project scope with stakeholders within project parameters established by project sponsors.

Obtains approval of business or functional requirements and system outputs from stakeholders and/or project sponsors.

Determines optimal business system technical design with IS&T.

Assigns tasks required for project completion.

Budgetary decisions will be deferred to Sr. Director, AOD.

Responsible for daily decision-making regarding prioritization, time management and communication.

Makes recommendations to health plan leadership regarding system, policy or process development needs and/or changes.

Uses professional judgment, organizational, industry and systems knowledge, and common sense in determining appropriate alternatives for problem solution.

 

DIMENSION:

Shared accountability for ensuring that assigned HealthPartners core administrative systems function and are supported in accordance with health plan operational and regulatory requirements.

Shared accountability for ensuring that HealthPartners core administrative systems are designed in alignment with HealthPartners IS & T and health care industry standards.

Direct or indirect accountability for the performance management of business and technical project team members assigned to system enhancement project.

Direct or indirect accountability for the successful implementation of assigned administrative systems development or enhancement initiatives within project parameters established by project sponsors – scope, schedule and budget.

Balances diverse needs of all areas affected by systems, with primary accountability to HealthPartners’ Administrative Operations and Development (AOD).

MAJOR CHALLENGES:

Meeting the diverse needs of multiple business areas and users.

Ensure that system design is in alignment with business requirements of both internal and external customers including, but not limited to: members, employers, regulators, auditors, and providers.

Understanding interdependence among internal health plan administrative systems and consequences of change to each.

Understanding interdependence among external customer systems and consequences of change to each.

Recommending priorities with limited resources.

Meeting an ambitious project implementation schedule.

Ability to deal with multiple, competing priorities.

Alignment of project resources in conjunction with established project schedule.