Business Analyst III

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.

Responsibilities:

• Conduct detailed root cause analysis on service or operational issues, synthesize findings, and communicate business needs and recommended solutions.
• Develop and maintain forecasting models and analytics dashboards using modern tools such as Excel, SQL, and BI platforms (Power BI/Tableau), with legacy tools (Access, Monarch) as needed.
• Integrate data across multiple systems and ensure data integrity for reporting and operational decision-making.
• Translate business needs into clear functional requirements and partner with IT to build, enhance, or troubleshoot system capabilities.
• Develop data-driven recommendations and implement process improvements that enhance efficiency, accuracy, and customer experience.
• Lead or contribute to project teams, facilitate working sessions, and deliver presentations to internal and external stakeholders.
• Own or support User Acceptance Testing (UAT), including test planning, execution, documentation, and validation of system enhancements or fixes.
• Prepare documentation for internal/external audits and support audit reviews by validating findings, addressing discrepancies, and recommending corrective actions.
• Provide mentorship and guidance to junior analysts, assist with onboarding new team members, and support workload distribution where needed.
• Perform other relevant tasks as assigned by management.

ADDENDUM FOR ENROLLMENT ANALYSTS:

• Build and maintain datasets, reports, analytics models, and dashboards from multiple data sources to identify trends and support forecasting for products, enrollment, and operational needs.
• Conduct detailed root cause analysis and collaborate with IT to deploy solutions, monitor outcomes, and ensure long-term issue remediation.
• Partner with vendors to reduce billing inaccuracies, streamline processes, control costs, and improve data quality.
• Provide advanced forecasting and analytics support to enrollment vendors, reconcile vendor transactions against internal systems, verify billing accuracy, and recommend improvements to contract or billing workflows.
• Serve as firstlevel support for ID cardrelated issues; analyze data, identify trends, and make recommendations to enhance system accuracy and member experience.

Education/Experience:

• High School Diploma/GED required.
• Bachelor's degree preferred (or equivalent experience in an analytical or operational capacity in lieu of degree).
• Minimum of seven (7) years' experience in an operational role, or analytical role.

Knowledge:

• Knowledge of Healthcare industry required.
• Knowledge of Project Management methodologies.
• May require knowledge of Horizon Blue Cross Blue Shields products and services.
• Working knowledge of organizational operating models and division objectives preferred.

Travel:

• Some travel may be required.

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.