Healthcare Business Analyst (Facets)

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

What You'll Do

• Partner with business teams to understand requirements and translate them into testable UAT scenarios.
• Develop and execute detailed test plans, scenarios, and scripts to validate system functionality.
• Leverage your FACETS expertise to identify defects, resolve inconsistencies, and improve claims processing accuracy.
• Monitor UAT progress, proactively remove obstacles, and recommend system improvements.
• Provide clear, timely status reports and recommendations to project stakeholders.
• Review and validate test evidence, ensuring readiness for production deployment.
• Maintain a well-organized repository of UAT documentation, scripts, and materials.
• Conduct root cause analysis, recommend solutions, and help implement process improvements.
• Support internal and external audit activities by preparing accurate documentation and reviewing findings.
• Collaborate cross-functionally to strengthen processes and enhance operational performance.

What You Bring

• Bachelor's degree preferred or equivalent relevant work experience.
• Minimum 4+ years of experience in an operational or analytical role.
• Required: In-depth knowledge of healthcare claims processing within FACETS.
• Knowledge of the healthcare industry and project management methodologies.
• Familiarity with enrollment, provider contracting, and ETL/SQL preferred.
• Strong technical skills, including Microsoft Office (Excel, Access, PowerPoint, Project, Visio).
• Analytical mindset, excellent problem-solving skills, and the ability to collaborate across teams.

Where You'll Work

Horizon employees must reside in New Jersey, New York, Pennsylvania, Connecticut, or Delaware. This is a Remote role, but requires the ability to come on-site to our Newark, NJ office.

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.