Solutions Analyst - Medicaid Operations Reporting

Highmark Health · Pittsburgh

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Job Description : 

JOB SUMMARY

For candidates located within a 50-mile radius of our Pittsburgh office, this position operates on a hybrid schedule, with mandatory in-office work on Tuesdays, Wednesdays, and Thursdays. Candidates residing outside this 50-mile radius are eligible for fully remote work. 

This job is responsible for one or more analytical aspects of the business products and services life cycle, within a sub-product scope (one or more data components). Uses regular judgement and discretion to collaborate with customers to understand data, reporting, and analytical capability needs, gather project and data specifications, create data sets, operational reports, and analytical deliverables to translate high-level business data needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities), analyze data to determine business problems, trends, or opportunities for process improvements, create/execute test cases, provide root cause analysis and corrective action plan, verify delivery of customer data needs, and ensure quality delivery. Also responsible for identification, documentation, and resolution of risks, defects and issues. Responsible for analyzing market trends for competitive insight to correlate into business value statements. Builds organizational and platform knowledge in one or more disciplines to advance professional track career. Uses functional and organizational knowledge to mentor junior resources.  Requires thorough understanding of data store and end systems impact of changes across multiple data stores and systems. 

ESSENTIAL RESPONSIBILITIES

• Work with customers, Data Engineers, Data Architects, Capability Managers, and other team members to capture capability needs and drive quality data and reporting solutions. Responsible for creation and maintenance of deliverables such as data set creation, operational reports, and analytical dashboards.

• Collaborate effectively with cross-functional teams, leveraging diverse data skills and perspectives to proactively identify and address data-related challenges across project phases, driving data-driven insights and solutions to ensure successful project delivery.

• Support various aspects of data and report delivery requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. 

• Assure compliance for required standards and all necessary approvals have been obtained throughout the data delivery lifecycle.

• Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.

• Other duties as assigned or requested.

EXPERIENCE

Required

• 3 years of experience in Information Systems or Technology

Preferred

• 1 year of experience in Lean/Six Sigma

• 1 year of experience in Health Insurance or Healthcare Industry

SKILLS

• Analytical Skills

• Problem-Solving

• Communication Skills

• Report Writing

• SQL

EDUCATION

Required

• Bachelor’s degree in Business Administration, Business Management, Information Systems or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.   

Substitutions

• None

Preferred

• Master's degree in Business Administration, Business Management, Information Systems or related field

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Six Sigma

• Project Management Professional (PMP)

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office- or Remote-based

Teaches / trains others

Occasionally

Travel from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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