Systems Software Programmer

Position Summary

The Business Systems Analyst, Enrollment & Member/Provider Services, is a cross‑functional role supporting both the Enrollment and Member/Provider Services (MPS) areas through the implementation of HealthRules Payer (HRP) and GuidingCare, as well as during post‑go‑live stabilization. This role provides critical operational support, ensures alignment between the two workstreams, and helps maintain data accuracy, workflow readiness, and system functionality.

The Analyst serves as a connector between business operations, IT, and external vendors, ensuring that system changes are implemented correctly and that both Enrollment and MPS are prepared for and supported through the transition to new platforms.

Key Responsibilities

Implementation Period

• Testing support, including UAT execution, regression testing, and validation of system behavior
• Data migration checking for enrollment, demographic, provider, and related datasets
• Reviewing configuration for accuracy and completeness across both systems
• Tracking issues, triaging defects, and following up to ensure timely resolution
• Developing and updating process documentation and standard operating procedures
• Supporting operational readiness and stabilization planning ahead of go‑live

Coordinating Between Enrollment & Member/Provider Services

• Mapping and managing integration points between the two workstreams
• Ensuring HRP and GuidingCare requirements are aligned across both functional areas
• Coordinating workflow changes that impact multiple teams
• Identifying and preventing duplication, misalignment, or conflicting decisions between departments

Post‑Implementation Responsibilities

• Providing ongoing system maintenance and configuration support
• Serving as first‑line support for operational issues related to HRP and GuidingCare
• Overseeing data quality checks and reconciliation activities
• Refining workflows and supporting continuous process optimization
• Acting as liaison between Operations, IT, and vendors on system enhancements, issues, and releases
• Helping maintain a positive member and provider experience by ensuring operational continuity and system accuracy
• Preserving and documenting institutional knowledge gathered throughout implementation and stabilization

Education

• Bachelor’s degree in Business Administration, Health Care Administration, Information Systems, Public Health, or a related field

OR

• Equivalent combination of education and relevant work experience in health plan operations, systems support, or business analysis