2 Jobs Available in Dallas, TX at Nautilus Insurance Company

Company Details

Company URL: berkleynet.com

Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker’s successful and speedy return to work is good for people and good for Berkley’s insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology as a way to deliver the best outcome for injured workers and Berkley’s operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers’ compensation cases.

To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley’s operating units with reliable results, and reduced time and expenses associated with case management.

Responsibilities

As a Business Analyst, you’ll play a critical role in helping BMMS reach its goals by carrying-out the Business Analyst “Key Functions” outlined below. The Business Analyst is multi-faceted and acts as a liaison between business, operations, other business analysts, and IT resources internal to BMMS and external with BMMS’ vendors and Berkley sister companies.  The Business Analyst’s objective is to perform the business analysis function to help BMMS achieve strategic, project based, and department level success wherever a business analysis resource is deemed appropriate and is deployed, and help educate fellow team members on Active Listening, Balanced Approach, Boldness, Critical Thinking, Integrity, and Quality Decision Making.

• Determine business analysis work that will be required during the planning phase of projects and process improvement efforts.
• Elicit and document business requirements for projects, including core product build & enhancements and implementations; business process workflows, service management issues; &/or identified opportunities for improvement. Requirements may include but are not limited to those that result in business and IT-based solutions including coding, configuration, EDI, reporting, process workflow, etc. These may impact BMMS only or BMMS’ vendors &/or Berkley sister company systems/programs.  Elicitation activities include leading large groups of diverse people within all levels of the organizations through detailed requirements gathering sessions.
• Analyze business requirements to verify clarity and completeness with business owners; validate every requirement gathered belongs within the scope of project or assignment by comparing it to the stated business need & objective; confirm & document assumptions and constraints.
• Analyze proposed solutions with the business owner and impacted IT &/or operational areas for clarity and completeness. Solutions may include changes or enhancements to systems/programs &/or operational workflows and may have impacts only internal to BMMS, to BMMS’ vendors, &/or to Berkley sister companies.
• Document high-level business requirements and/or detailed IT specifications using department-approved templates/formats (where applicable) to produce requirements artifacts that may include: Business Requirements Documents (“BRDs”), Policy & Procedure documents (“P&Ps”), IT Functional Specifications/User Stories, Report Specifications, Workflow Documents (Visios).
• Contribute to test design, planning, scenario-building, and validation.
• For service management issues: Identify root cause(s); lead resolution for specific issues; document issue, progress, and resolution clearly/completely in accordance with department standards; follow-up on root cause and lead root cause resolution with necessary business owner escalations & approvals.
• Assist department in fulfilling goals and objectives by carrying-out other duties as assigned.
• Mentor Associate Business Analysts.
• Identify areas for improvement in department processes and raise recommendations to management.

Qualifications

Skills and Experience

• Minimum 2-4 years of experience in a business analyst role with similar functions demonstrating increasing level of responsibility over time required.
• Workers’ compensation, medical billing, or managed care service industry experience strongly desired.
• Demonstrated ability to successfully manage multiple complex assignments at one time employing multiple of the position’s essential functions independently.
• Experience managing requirements within the scope of a project required.
• Experience with writing detailed IT specifications strongly desired.
• Ability to operate computers including working knowledge of major Microsoft Office applications including MS Word; Excel; Power Point; Visio.

Core Competencies

• Active Listening - Demonstrates true interest in other people when they talk seen by their questions and attention. Practices attentive and active listening. Hears people out prior to interrupting or making a conclusion. Restates what they heard to ensure they are aligned with the other person and to demonstrate understanding.
• Balanced Approach - Can hear people out prior to acting. Seeks information and data prior to making a decision or conclusion. Is willing to bring others along in their learning. Can honor existing processes yet challenge where appropriate.
• Boldness - Is willing to say what needs to be said in any situation. Provides direct feedback to others. Is able to let people know where they stand. Can deal with tough situations head on without hesitation and take tough stands. Is not afraid to take negative action when necessary. Can take calculated risks. Can receive direct feedback without emotionally reacting negative.
• Critical Thinking - Uses rigorous logic and methods to solve difficult problems with effective solutions. Looks for solutions in all possible areas. Can see future problems and cause and effect relationship. Is able to provide good fact-based analysis. Can do root-cause-analysis to get past the obvious surface of a problem. Knowledgeable in experimenting and testing their own thoughts to prove concept in execution.
• Quality Decision Making - Makes good decisions (without considering how much time it takes) based upon the use of data, experience and judgment. Is seen as a consistently accurate decision maker. Is sought out by others for their thoughts. Seeks to ask questions first for understanding to ensure quality of decision. Considers all factors and impacts in decision making. Not quick to form a conclusion. Seeks additional information in making a decision.
• Integrity - Is widely trusted. Is seen as a direct and honest individual. Can present direct facts in a fair manner. Can keep the confidence of others. Admits mistakes. Has a set of core values that they hold to as seen by others. Is good at driving the right values in others and holding people accountable for the wrong values. Their actions speak louder, or as loud, as their words. Will honor commitments made even if it is not to their advantage. Treats all people in a fair manner regardless of ranking or circumstances.

Travel Requirements

Domestic U.S. travel required (up to 10% of time)

The company offers a competitive compensation plan and robust benefits package for full time regular employees.

• Salary Range: 75k - 95k
• Benefits: Health, Dental Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.

The actual salary for this position will be determined by a number of factors, including the scope,

complexity and location of the role; the skills, education, training, credentials and experience of

the candidate; and other conditions of employment.

Additional Company Details

The Company is an equal employment opportunity employer.