We are hiring a Business Systems Analyst Specialist on the Payments, Accums & Encounters team at BlueCross BlueShield of Tennessee!

In this role, you will serve as a key liaison between business and technology teams, supporting Medicare, Medicaid, and TennCare claims initiatives and helping ensure compliance with evolving federal and state regulations. You will partner with stakeholders across business operations, technology teams, and external agencies to analyze regulatory changes, assess business and system impacts, document requirements, and support implementation efforts. This position will play a critical role in a deep dive into end-to-end Medicare and Medicaid claims processes, helping capture institutional knowledge, identify gaps, and drive process improvements while developing subject matter expertise in claims processing and regulatory compliance.

Ideal candidates for the role will bring:

• Strong business analysis, problem-solving, and root cause analysis skills.

• The ability to independently interpret complex program changes and translate them into actionable business requirements.

• Experience collaborating across business and technical teams to support system and process changes.

• Excellent communication skills and the ability to build relationships with internal stakeholders and external regulatory agencies.

• A strong learning mindset and the ability to become a trusted subject matter expert in a highly regulated environment.

Preferred qualifications:

• Healthcare payer or health insurance industry experience.

• Experience supporting Medicare, Medicaid, claims processing, or CMS-related initiatives.

• Knowledge of regulatory compliance and the impact of federal and state mandates on business processes and systems.

• Experience with data mapping, systems integrations, or requirements documentation.

• Familiarity with SQL queries and experience navigating and analyzing data within databases would be beneficial.

Note:

• This is a remote, work-from-home position, but the final round of interviews will take place on-site in our Chattanooga, TN office.

• Sponsorship is not available for this role.

Job Responsibilities

• Providing recommendations for addressing and resolving business issues, for a specific business group.
• Directing business process improvement projects for internal business groups, aiming to improve business results.
• Identifying and documenting all system constraints, implications and consequences of various proposed system changes.
• Provides direction in assessing impact of change, defining business rules, and implementing solutions across a broad range of functional boundaries.Competent to work at the highest technical level of most phases of systems analysis while considering the business implications of the application of technology to the current and future business environment.Leads requirements analysis and verification, ensuring that requirement statements are complete, consistent, traceable, feasible, and verifiable
• Collaborates with the technical and project teams to ensure that the results of the project fully satisfy the needs embodied in the requirements.
• Proactively identifies opportunities for improvement in requirements gathering, documentation, and translation.
• May serve one or more project team roles, such as project lead, business systems analyst lead, or technical lead, for small to medium efforts or manage phases of medium to large efforts.

Job Qualifications

Education

• Bachelor's Degree in a Computer Sciences related field or equivalent work experience

Experience

• 1 year - Leading requirements development efforts required
• 1 year - Extensive systems analysis, design and project management experience required.
• 3 years - Experience in Information Technology and systems analysis.

Skills\Certifications

• Knowledge of information technology concepts, application development methodology, terminology, and standards to actively conduct and/or engage in hardware and software related discussions relative to all assigned projects.
• Demonstrated ability to interpret and translate technical and/or or complex concepts into information meaningful to project team members and/or business personnel.
• Demonstrated presentation and team facilitation skills
• Outstanding negotiation, presentation, and facilitation skills
• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Possess skills of paying attention to detail
• Ability to manage multiple projects and priorities
• Strong analytical and conceptual skills; ability to explain solutions/concepts/theories to varied business units

Number of Openings Available

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Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.