Systems Analyst - Health Plan

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Independently supports the design, implementation, and maintenance of software systems to meet organizational needs. Independently troubleshoots system issues, provides end-user training, and manages project coordination to ensure efficient delivery of technology solutions. This role works closely with cross-functional teams, including senior analysts and experts to ensure system functionality aligns with system goals and contributes to operational efficiency. With a focus on continuous improvement, the role also includes managing system upgrades, resolving high-priority incidents and driving process improvements to enhance overall system performance.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s degree in Computer Science, Information Technology or a related field.

2 Relevant certifications and/or proficiencies may be required for this position, with a target completion within 90 days following formal training provided by WVUHS Information Technology.

EXPERIENCE:

1. In lieu of a degree, a minimum of four (4) years of relevant experience will be considered.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Minimum one (1) year relevant experience.

EXPERIENCE:

1. Operational experience in applicable business, clinical, payer or web application systems, including workflows, focused on driving efficiency and optimization.

2. Proficiency in systems administration and providing strategic insights and improvements to business operations.

3. Experience working in inpatient and outpatient clinical settings, with a focus on improving patient care processes through advanced system implementations.

4. Understanding of clinical data management and healthcare interoperability standards (HL7, FHIR, DICOM) to ensure seamless data exchange and compliance.

5. Knowledge in Cloud-based healthcare applications and web services, ensuring secure, scalable, and efficient system architecture supported by this role.

6. Knowledge of reporting tools, delivering actionable insights and enhancing decision-making processes through comprehensive data analysis and reporting capabilities.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. System Maintenance, Updates, and Innovation:

• Diagnose and Resolve IT Issues: Daily troubleshooting and problem-solving efforts to maintain and optimize system functionality, escalating issues as needed.

• Execute System Modifications, Implementation, and Testing: Implement and test system updates for basic workflows, ensuring reliable functionality and supporting optimization initiatives.

• Perform Functional and Integrated Testing: Engage in testing activities to verify and optimize system performance, documenting results and identifying areas for improvement.

• Perform System Error Corrections and Optimizations: Identify, diagnose and correct system errors to maintain smooth operations and timely resolutions.

• Perform User Security Management: Apply user security settings to uphold data integrity and optimize access control.

• Stay Current with Industry Trends and Optimization Techniques: Leverage industry resources (journals, conferences, user groups) to stay updated on vendor offerings, emerging system features, and optimization strategies.

• Identify opportunities for System Enhancements and Optimization: Recommend and implement updates or new functionalities based on organizational needs, focusing on system efficiency and best practices.

• Data Import/Export and Basic Reporting: Manage data transfers and generate reports, contributing to accurate data handling and reporting optimization.

2. Collaboration and Communication:

• Collaborate Effectively and Proactively Communicate: Work closely with team members, providing clear updates to ensure alignment with project goals.

• Effectively Communicate with Business Partners: Engage with business partners to understand needs, gather requirements, and ensure technical solutions align with business objectives.

• Foster a Positive Team Environment: Contribute to a supportive, respectful, and collaborative work culture.

• Demonstrate Openness to Feedback and Continuous Improvement: Actively seek and apply feedback and suggest process improvements.

• Engage in Professional Development: Participate in training and development to enhance skills and stay current in best practices.

• Ensure Reliable Remote Communication: Maintain consistent communication with the team for seamless collaboration.

3. Project Coordination:

• Project Planning and Scheduling: Help identify project stakeholders, and help define scope, plan, deliverables, schedule, and milestones.

• Coordination: Oversee a project, acting as a point of contact for team members, colleagues, vendors, and stakeholders to ensure the smooth execution of projects.

• Communication: Ensure communication of information within the project. Including facilitation of regular meetings, documentation of meeting notes and action items.

• Documentation and Reporting: Maintain detailed and organized project documentation, including project scope, plans, reports, and status updates.

• Risk Management: Identify risks, create risk mitigation plans, and ensure contingency measures are in place.

• Issue Management: Identify problems in the project and assist in finding solutions to keep the project on track.

4. Training and Education:

• Provide End-User Support and Training: Deliver classroom, one-on-one, and/or remediation training to support end-users' effective use of systems.

• Assess User Readiness and Abilities: Evaluate staff readiness and skill levels to ensure proper use of systems and identify any additional training needs.

• Deliver Systems Support: Offer ongoing end-user systems support to resolve issues and enhance system proficiency.

• Content Development: Contribute to curriculum development to support the creation and delivery of effective training materials that align with organizational workflows and objectives.

5. Continuous Learning and Knowledge Development: ·

• Demonstrates consistent commitment to expanding technical knowledge. ·

• Utilizes resources such as application community sites, professional networks, and industry tools.

• Applies learned skills to support tasks and contribute to team objectives. ·

• Attends relevant training sessions and workshops.

• Follows industry news and monitors advanced trends.

• Recognizes key areas for personal and professional improvement.

• Actively participates in team discussions and knowledge-sharing activities.

• Conducts research for projects and contributes to content development.

• Accepts and incorporates feedback from peers and supervisors.

• Shares knowledge informally with peers.

• Collaborates with other teams to gain a better understanding of their processes.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping are necessary body movements utilized in performing duties through the work shift.

2. Ability to sit for extended periods of time.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. The work environment is a standard office environment.

2. This position may require travel to other West Virginia United Health System (WVUHS) facilities or affiliated sites to assist with implementations, training, and/or support.

SKILLS AND ABILITIES:

1. Analysis and Assessment: Solid experience in analyzing business needs, translating them into functional specifications, and aligning them with technical solutions. Competent in leveraging data insights to support decisions on software procurement, installation, and configuration. Demonstrates strong ability in utilizing tools such as process maps, workflow diagrams, and data analytics to design and support system design, training, and problem resolution.

2. Attention to Detail: Demonstrates strong ability to troubleshoot and systematically test systems, identifying and resolving potential issues to maintain functionality and reliability.

3. Communication and Relationship Building, and Teamwork: Demonstrates strong written and verbal communication skills to effectively convey technical information clearly. Applies solid interpersonal skills to build relationships and encourage collaboration across teams. Actively engages in group problem-solving, sharing expertise, and contributing to a positive and productive team dynamic.

4. Adaptability and Change Management: Demonstrates strong ability to handle unexpected changes and system issues, applying effective coping skills to minimize disruptions and support operational continuity.

5. Time Management: Demonstrates strong ability to prioritize and balance multiple responsibilities and deadlines, ensuring tasks are completed accurately and on time while supporting team objectives.

Additional Job Description:

As a Systems Analyst supporting Epic Tapestry, you will play a key role in the technology that powers our health insurance operations. Our team partners closely with business leaders across Enrollment, Benefits, Claims, Premium Billing, Provider Network Management, Finance, Customer Service, Care Management, and Regulatory Compliance to design, implement, and support technology solutions that ensure our members receive accurate, timely, and high-quality service.

This position offers the opportunity to work on complex payer operations supporting multiple lines of business, including Medicare Advantage, Commercial, and ACA Marketplace products. Analysts are involved throughout the full system lifecycle—from gathering business requirements and designing workflows to system configuration, testing, implementation, production support, and ongoing optimization.

Our Epic Tapestry environment supports critical business functions including:

• Benefit and product configuration
• Member enrollment and eligibility
• Claims processing and adjudication
• Premium billing and payment processing
• Provider data and network management
• Regulatory and CMS compliance
• Customer service workflows

Success in this role requires strong analytical thinking, collaboration, and a desire to solve complex business problems. Analysts work closely with operational leaders, clinical teams, vendors, and technical partners to improve business processes while ensuring system stability, data integrity, and compliance with federal and state regulations.

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

5816 SYSTEM IT Health Plan

Address:

315 Point Marion Road

Morgantown

West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.