New

BPO Oversight Specialist III - Hybrid

Blue Cross Blue Shield of Arizona
United States, Arizona, Phoenix
Aug 27, 2026
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This position is hybrid within the state of AZ only.This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona. PURPOSE OF THE JOB On behalf of internal and external customers, gather and document business requirements, provide research and analysis related to project deliverables or production break/fix issues, conduct user acceptance testing, and act as a liaison among business customers, external customers, project teams, and Information Technology. REQUIRED QUALIFICATIONS Required Work Experience All Levels: 3 years of experience in healthcare or operations 3 years of experience in a healthcare production or quality auditing environment Levels 2-4: 2 years of experience in a role demonstrating the ability to communicate with diverse groups inside and outside the business 2 years of experience triaging member and/or provider issues from initiation through resolution 3 years of experience developing and implementing process improvement initiatives Required Education All Levels: High school diploma or GED in a general field of study Required Licenses None Required Certifications None PREFERRED QUALIFICATIONS Preferred Work Experience All Levels: 5 years of experience in healthcare or operations 5 years of experience in a healthcare production or quality auditing environment Levels 2-4: 1 year of project management experience 1 year of management experience 3 years of experience triaging member and/or provider issues from initiation through resolution 5 years of experience in a role demonstrating the ability to communicate with diverse groups inside and outside the business 5 years of experience in healthcare or insurance, with an emphasis on business analysis Preferred Education All Levels: Bachelor's degree in Computer Science, Information Systems, Business, or a related field Preferred Licenses None Preferred Certifications None ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES LEVEL 1 Write and review business requirements, process flows, specifications, and change requests Write test scripts, perform testing, and conduct post-production validation Conduct research and analysis to resolve issues involving electronic transactions, customer service applications, claims adjudication systems, reporting, and process efficiency Track assigned issues through resolution Provide first- or second-level support to internal and external customers Apply problem-solving skills to improve procedures and processes, resolve system deficiencies, and implement enhancements Serve as a liaison among internal customers, external customers, and Information Technology Communicate system and process changes to affected business areas LEVEL 2 In addition to the responsibilities of Level 1: Develop moderately complex business requirements and process-flow specifications for large projects involving multiple departments or systems, with limited management direction Support external customers with onboarding for healthcare electronic data interchange processing and HIPAA Transaction and Code Set compliance Provide subject matter expertise related to electronic transactions and other corporate systems when prioritizing work or researching issues Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities Lead small- to medium-sized projects Serve as a user acceptance testing coordinator, including developing test strategies and plans Interpret design specifications and compare them with defined business needs to ensure compatibility, consistency, and completeness Resolve differences among customers and team members to support organizational and project goals Use existing reporting tools to develop and execute data queries for ad hoc requests Understand data-source structures Understand electronic data interchange formats, syntax, and file-transfer protocols Support multiple business segments Mentor Level 1 analysts LEVEL 3 In addition to the responsibilities of Levels 1 and 2: Develop complex business requirements and process-flow specifications for large projects involving multiple departments or systems, with little or no management direction Decompose high-level project information and evaluate project components to forecast the required work effort Serve as the lead business analyst for large or complex projects Interpret business and technical design specifications Resolve conflicts between design specifications and defined business needs Fully support all business segments Mentor Level 1 and Level 2 analysts LEVEL 4 In addition to the responsibilities of Levels 1, 2, and 3: Ensure that service-level agreements between the department and operational or technical areas are met Serve as the lead business analyst for large or complex projects with minimal guidance from a lead or manager Mentor analysts at all levels Proactively identify opportunities to improve processes and procedures in support of customer satisfaction and corporate goals ALL LEVELS Each progressive level includes the ability to perform the essential functions of lower levels and mentor employees at those levels The position has an onsite expectation of 1 day per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Participate in an on-call rotation Perform other duties as assigned REQUIRED COMPETENCIES Required Job Skills All Levels: Strong analytical skills supporting independent and effective decisions based on customer input and research Strong problem-solving skills Strong time-management skills Basic proficiency with Microsoft Word, Excel, Outlook, Visio, and PowerPoint Basic proficiency with query tools Strong understanding of file handling and data translation Excellent verbal and written communication skills Ability to interact professionally and maintain positive working relationships with diverse groups Required Professional Competencies All Levels: Ability to prioritize tasks and manage multiple priorities, sometimes under strict time constraints Ability to build synergy within a diverse team in an evolving environment Ability to exercise independent judgment and apply creative problem-solving techniques Ability to anticipate downstream impacts and incorporate those considerations into decisions Perseverance when facing resistance or setbacks Required Leadership Competencies Support the priorities and direction of corporate leadership Apply sound management decision-making skills and perform effectively in the absence of management Manage conflict effectively Present concepts effectively to employees at varying organizational levels The presentation competency applies to Levels 2-4. PREFERRED COMPETENCIES Preferred Job Skills All Levels: Advanced knowledge of and experience developing business requirements, conducting user acceptance testing, and using supporting tools Familiarity with HIPAA compliance validation tools such as EDISM, SpecBuilder, or ClarEDI Familiarity with claims and customer service processes Experience supporting business users of web portals Experience with change-management activities Formal business analyst training Preferred Professional Competencies All Levels: Commitment to identifying solutions that meet customer needs Ability to work with ambiguous or conflicting information while remaining focused on the intended outcome Experience delivering public-speaking presentations within the industry Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group. Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.