**Job Description** We are seeking a detail-oriented and collaborative Business Systems Analyst to bridge Medicare claims business needs with technical solutions. In this role, you will leverage your functional and technical expertise to define, evaluate, and validate requirements, as well as design effective solutions for small to moderately complex business challenges within your domain. As a key liaison between Medicare claims operations, Utilization Management, Provider Network, Payment Integrity and IT, you will ensure processes and systems align seamlessly, minimizing operational impacts. Responsibilities include supporting problem resolution, data analytics, testing, software upgrades, and related projects to enhance system performance and user experience. Your work will drive efficiency and innovation across the organization. **What You’ll Do** **Technical Support/Business Expertise** + Provide technical knowledge and support in operational system/application and procedural issues to the Medicare claims business and IT and help the business find technical solutions to meet their goals. + Work in some phases of systems analysis and consider the business implications of the application of technology to the current business environment + Provide ongoing user support for ad hoc questions, inquiries, and service requests. + Provide timely and accurate data/root cause analysis, trend reporting on inventory, productivity, user activity, and system performance on a regular and/or as requested basis. **Issue Resolution** + Resolve medium, moderately complex production issues by: + Performing initial triage for severity and business impact of system/application failures. + Troubleshooting and analyzing to determine root cause of issues + Developing applicable business processes and solutions to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met. + Coordinating with IT, other teams and vendors as needed to communicate issues and devise and implement long term remedies. + Develop system support processes with IT; coordinate daily to resolve production support issues, including application failures and user errors; document, track and report all system support activities **Project/Program Support** + Work collaboratively on projects and initiatives with the Medicare claims team and IT by eliciting and documenting business requirements and preparing appropriate functional specifications while considering technical capabilities of the system/application. + May act as Business Lead/Coordinator on moderate single area/department projects. **Business Testing** + Coordinate testing plans with Business area and IT + Serve as point of contact for business testing activities and ensure testing will appropriately meet business requirements + Document and may, in some cases, execute test plans and scenarios + Analyze and verify testing results for accuracy, relevance and completeness + Provide impact assessments and make assist in formulating recommendations to the business owner regarding issues, risks, etc. + Assist IT with hardware and software upgrades, security changes, and architectural enhancements as needed. **System Configuration** + Configure and maintain moderately critical system tables and data elements across multiple system environments + Analyze, develop and implement configuration changes to improve system performance and user efficiency + Monitor configuration for accuracy and compliance to change control processes. **What You Bring** + Bachelor's degree or advanced degree (where required) + 3+ years of experience in related field. + In lieu of degree, 5+ years of experience in related field. **Bonus Points** + 1-2 years of Medicare and Medicaid experience or a highly regulated operational environment **– highly preferred** + Lean Six Sigma/continuous improvement training and/or certifications **– preferred** + Data extraction experience using SQL – **highly preferred** + Experience with Facets claims processing system – **preferred** + In depth understanding of health care business operations – **highly preferred** **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 (https://careers.bluecrossnc.com/global/en/benefits)    **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._ $66,998.00 - $107,197.00 **Skills** Data Extraction, Facets, Lean Six Sigma (LSS), Medicaid, Medicare, Structured Query Language (SQL) **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 (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-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 or hiring process, please notify HR at HR.Staffing@bcbsnc.com . **For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:** 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