Excellus BCBS · 3 weeks ago
OpEx Optimization Business Architect I/II/III
Johnson City, NY
Full-time
Hybrid
Mid, Senior Level
$60K/yr - $107K/yr
6+ years expExcellus BCBS is seeking an OpEx Optimization Business Architect to partner with both business and technical teams to develop high quality deliverables across all phases of project implementation. The role involves mentoring, driving technology use, and providing support to business groups while focusing on process improvement and operational efficiencies.
Health CareHealth InsuranceNon Profit
Responsibilities
Partners with business leaders to understand the goals of the department/division and defines preferred process aligned with executing the strategy to achieve goals and objectives of the organization. Closely follows the strategic direction set by management when establishing near term goals and driving process change
Evaluates operational trend data for process improvement opportunities. Explores various industry standard methodologies and identifies opportunities to integrate changes into current initiatives. Facilitates completion of process improvement work through standard tools, such as Planview, Service Requests, and project proposals
Defines, prioritizes, and manages scope, small-large-medium sized teams and work efforts. Plans, schedules, monitors, and reports on activities related to process improvement initiatives
Leads initiatives to accelerate business results through application of process improvement thinking, tools and techniques. Assesses and monitors projects, including problem identification, developing potential solutions, implementing them and evaluating outcomes involving various staff as needed
Identifies, assesses and solves complex business problems for area of responsibility, where analysis of situations or data requires an in-depth evaluation of variable factors. Responsible for troubleshooting and using all resources to find needed answers, and for root cause analysis on findings identified; this includes assessing when to elevate issues and doing so as needed
Responsible for enhancing communication within and outside the department/division on key priorities and other impacts of findings. Fosters a positive environment of continuous process improvement. Constantly exploring ways to increase efficiencies and productivity, reducing waste, and reducing costs
Meets with management, sponsors, and project teams to review project scope/progress and resolve project issues. Ensures that departmental practices comply with State and Federal laws
Selects and applies appropriate tools to accurately estimate and plan the work of teams or project groups within agreed policies. Produces work plans according to required standards. Works with colleagues to produce/recommend/develop long-term plans
Monitors and reports on the progress of the resolution of high impact problems according to established standards. Handles those exceptions that have been referred from below relating to schedules, working methods, resources, staff matters, or technical difficulties. Passes decisions clearly outside scope upward, including proposed solutions whenever appropriate
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures
Regular and reliable attendance is expected and required
Performs other functions as assigned by management
Defines, prioritizes, and manages scope, large-medium sized teams and work efforts
Acts independently to assess and monitor projects, including problem identification, developing potential solutions, implementing them and evaluating outcomes involving various staff as needed
Acts as lead and as contact Health Plan-wide for projects. Responsible for answering questions regarding project and education for project internally and externally
Engineers solutions that optimize business processes and utilize design best practices, provides Pega requirement capture, elaboration and confirmation of system and business process optimization from contract/proposal initiation to final operational stage
Develops, proposes, and completes project proposals/business case. Establishes appropriate metrics for measuring key project criteria. Leads and guides the development of various elements of the identified solutions. Solicits input from IT and the business as a part of solutions development and collaborates Data Analytics to ensure implementation of Health Plan data model within designed solutions
Maintains currency on emerging technologies and process / project management techniques. Researches and identifies areas of innovation with the intent to advance business capabilities by the use of IT and system configuration
Coaches others to progress cross-functional skill development and fosters relationships between business teams and technical teams. Provides input to organizational training initiatives based on identified knowledge and skill gaps
Helps to define and evolve functional roles and responsibilities in order to ensure a greater understanding of best practices. Disseminates knowledge on design principles and implementation techniques via published papers and/or presentations
Oversees the creation, development and ratification of business architect standards. Mentors and assists staff in doing so
Qualification
Required
Six (6) or more years of cumulative years of related experience required or a Bachelor's degree in a related field
Experience in the Health Plan or healthcare industry especially as it relates to overall health insurance value chain and processes preferred
Demonstrated analytical and problem-solving skills
Demonstrated ability to approach technical challenges with determination and optimism
Demonstrated ability to quickly understand new concepts and to come up with original solutions
Ability to work in a team environment and communicate effectively to management and peers, both written and verbal
Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer
Ability to travel across the Health Plan service region for meetings and/or trainings as needed
Ability to work in a home office for continuous periods of time for business continuity
Preferred
Prior professional, co-op or internship experience in analysis, requirements gathering, design and development of enterprise application systems or relevant college coursework
Experience within an Agile environment, software architecture, service-oriented architecture implementation, and experience designing and developing process-based solutions
Experience writing requirements and/or user stories that are clear, concise and well organized
Two (2) additional years of cumulative years of related experience required Eight (8) total and a minimum of two (2) years of progressive experience in analysis, requirements gathering, design and development of enterprise application systems
Experience working with specific Pega products, framework and functional design
Possess one of the following certifications: CSA (Certified System Architect), CSSA (Certified Senior System Architect), LSA (Lead System Architect) CPBA (Certified Pega Business Architect)
Advanced experience with operational and technical analysis and interpretation
Experience designing and developing process-based solutions
Excellent time management and organization skills, with the ability to manage multiple competing priorities
Demonstrates aptitude to learn quickly, with a superb attention to detail and process orientation
Ability to think creatively and strategically with a focus on achieving outcomes
Two additional years of cumulative years of related experience required. Ten (10) total and a minimum of five (5) years of progressive experience in analysis, requirements gathering, design and development of enterprise application systems
Possess one of the following certifications: CSA (Certified System Architect), CSSA (Certified Senior System Architect), LSA (Lead System Architect) CPBA (Certified Pega Business Architect)
Demonstrable experience with project and resource planning
Advanced understanding of the differences between integrated, interdependent, and interfaced systems and their impacts on each other
Ability to judge severity of problems and the need to escalate to management
Benefits
Participation in group health and/or dental insurance
Retirement plan
Wellness program
Paid time away from work
Paid holidays
Company
Excellus BCBS
Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York.
5001-10000 employees
H1B Sponsorship
Excellus BCBS has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (18)
2023 (12)
2022 (15)
2021 (17)
2020 (20)
Funding
Current Stage
Late StageLeadership Team
Jeremy Donath
Director, Provider Reimbursement Analytics & Operations
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