Claims Operations Systems Analyst

Summary

Join Gravie as a Claims Operations Systems Analyst and become a subject matter expert for our claims processing system. You will be a functional lead on large technology projects, designing, implementing, and testing changes to claims technology platforms. Collaborate with stakeholders to prioritize requests, conduct root cause analysis, and coordinate testing. Provide platform and process expertise, create and maintain SOPs, and support strategic technology improvements. Maintain vendor platform functionality and build strong vendor relationships. Facilitate internal user groups and demonstrate commitment to Gravie's core values. This role requires a Bachelor's degree or equivalent experience, 5 years in business analysis/product management within healthcare, expertise in claims adjudication, and strong analytical and communication skills.

Requirements

• Bachelor’s Degree or equivalent experience
• 5 years of experience in business analysis and/or product management within the healthcare industry
• Expertise in end-to-end claim adjudication processes and applications
• Experience supporting complex processes and multi-layered projects
• Exceptional analytical, conceptual thinking, and problem-solving skills
• Advanced technical skills (familiarity with Javelina or similar platform)
• Strong communication, documentation, and reporting skills, with experience delivering presentations
• A track record of delivering results through collaboration and effective project management

Responsibilities

• Provide platform and process subject matter expertise on claims systems and processes to support users across the organization
• Create and maintain applicable Standard Operating Procedures (SOPs), user manuals and desk-level procedures
• Support strategic technology and process improvement projects, providing gap analysis, requirements gathering and user acceptance testing
• Maintain vendor platform functionality, monitoring platform KPIs and ensuring alignment with organizational SLAs/KPIs that depend on vendor performance
• Coordinate the testing process for the Javelina platform, ensuring that all teams adequately test system functions based on their daily operations and any defect resolutions outlined in the release
• Build strong vendor relationships during implementation, establishing issue management and SLA monitoring; transition vendor ownership off to other members of HPA as appropriate
• Facilitate internal user groups, seeking feedback on vendor platforms’ ease of use, accessibility and compatibility with other Gravie and vendor systems
• Demonstrate commitment to our core values of authenticity, curiosity, creativity, empathy, and results-driven outcome orientation

Preferred Qualifications

• Previous start up company experience
• Javelina claims system experience
• Understanding of stop-loss and reinsurance arrangements and operations
• Business Analyst or Product Owner certification
• Project Management and/or Scrum Master Certification
• Six Sigma Green Belt certification

Benefits

• Standard health and wellness benefits
• Alternative medicine coverage
• Flexible PTO
• Up to 16 weeks paid parental leave
• Paid holidays
• A 401k program
• Cell phone reimbursement
• Transportation perks
• Education reimbursement
• 1 week of paid paw-ternity leave