Job Description Responsible for the elicitation, prioritization, and conversion of business/functional requirements to system requirements, as well as provision of analysis for applications in production (large and/or more complex initiatives). Responsible for the development of functional designs for new, customized, or enhanced systems. The ultimate outcome of this role is the production of clear, timely, precise and accurate technical designs that are traceable to documented business/functional requirements and guide the successful design, development and deployment of IT Solutions. What You’ll Do Partner with business stakeholders and technical teams to gather, analyze, prioritize, and document business and functional requirements. Translate business needs into functional system designs and technical requirements for new, enhanced, or customized solutions. Analyze end-to-end business processes, system workflows, and technical dependencies to identify impacts, risks, and opportunities for improvement. Conduct gap analyses and provide recommendations for system enhancements, process improvements, and solution strategies. Ensure traceability between business requirements, functional designs, development efforts, and delivered solutions. Leverage SQL, Facets data structures, and analytical tools to support functional analysis, testing, troubleshooting, and production support activities. Collaborate with developers, architects, analysts, and business teams to evaluate solution alternatives and balance business needs, usability, performance, and technical constraints. Provide subject matter expertise for system functionality, business processes, and application design. Support implementation, testing, and production readiness activities for system enhancements and releases. Mentor junior analysts and provide guidance on analysis, documentation, and solution design best practices. What You Bring    Bachelor's degree or advanced degree (where required) Strong understanding of healthcare claims processing and healthcare payer operations. Strong understanding in Facets Claims process, IPP(BlueCard) and FEP is preferred 5+ years of experience in systems analysis, business analysis, Facets, Blue Card (IPP) or a related field In lieu of degree, 7+ years of related experience Bonus Points  Experience gathering requirements, developing functional designs, and supporting technology implementations Strong analytical, problem-solving, and communication skills Experience using SQL for data analysis and system investigation 5+ years of hands-on experience with TriZetto Facets, Blue Card(IPP) and FEP is preferred Experience with Facets Claims modules and IPP Claims process Experience configuring, customizing, integrating, and supporting Facets applications Experience in .NET programming and the ability to analyze the code. Knowledge of healthcare payer operations and related business processes Experience evaluating upstream and downstream system impacts in complex enterprise environments What You’ll Get  The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community   Work-life balance, flexibility, and the autonomy to do great work    Medical, dental, and vision coverage along with numerous health and wellness programs    Parental leave and support plus adoption and surrogacy assistance    Career development programs and tuition reimbursement for continued education    401k match including an annual company contribution    Learn more    Where You’ll Work Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused. In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter. Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process. Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $98,092.00 - $156,947.00 Skills _____________________________________________________________________ JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected]. About Us It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. Authorization to Work in the United States We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español. Request Accommodations Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [email protected]. Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming

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